Individual
MISS MIRANDA MICHELLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
147 E KING ST APT 1W, FRANKLIN, IN 46131-1778
(317) 605-2458
Mailing address
147 E KING ST APT 1W, FRANKLIN, IN 46131-1778
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001920A
IN
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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