Individual
SUSAN GICZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
119 N INDIANA AVE, CROWN POINT, IN 46307-4112
(219) 663-2532
Mailing address
209 CAMELOT EST, PORTAGE, IN 46368-5203
(219) 940-3507
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002765A
IN
Other
Enumeration date
03/26/2017
Last updated
03/26/2017
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