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Individual

DENISE MARIE DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS OT

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004693A
IN
225XH1200X
Hand Occupational Therapist
5527
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200922680
IN
01
P01023494
MEDIDCARE RR
IN
Enumeration date
08/24/2007
Last updated
05/24/2012
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