Individual
MISS JENNIFER L BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
11550 N MERIDIAN ST STE 312, CARMEL, IN 46032-4562
(317) 815-0781
Mailing address
3610 DRIFTWOOD DR S APT 100, LAFAYETTE, IN 47905-6045
(317) 439-8102
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
31003827A
IN
Other
Enumeration date
01/20/2010
Last updated
01/20/2010
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