Individual
BRENT DEJULIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR
Contact information
Practice address
426 S ALABAMA ST STE 200, INDIANAPOLIS, IN 46225-3301
(317) 528-6804
(317) 528-3781
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005589A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300020791
—
IN
Enumeration date
05/11/2017
Last updated
05/08/2023
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