Individual
MISS CARMEN LYNN VAN KLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
140 S VIANT ST APT B, LOWELL, IN 46356-2362
(219) 213-0604
Mailing address
140 S VIANT ST APT B, LOWELL, IN 46356-2362
(219) 213-0604
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002666A
IN
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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