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Individual

CORRINE SISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007428A
IN
225XH1200X
Hand Occupational Therapist
31007428A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300069712
IN
01
31007428A
STATE LICENSE
IN
Enumeration date
06/15/2021
Last updated
05/24/2024
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