Individual
MS. THERESA RENEE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
604 RENNAKER ST, LA FONTAINE, IN 46940-9045
(765) 662-9350
Mailing address
1622 DARIEN DR, FORT WAYNE, IN 46815-7835
(260) 748-0224
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001380A
IN
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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