Individual
ALLISON LEE ANTOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
21 SOUTH PARK BLVD., SUITE 21, GREENWOOD, IN 46143-8838
(317) 449-2104
(317) 520-8200
Mailing address
3500 DEPAUW BLVD., SUITE 3070, INDIANAPOLIS, IN 46238-6135
(317) 449-4833
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
31002997A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034906
NBCOT BOARD CERTIFICATION
—
05
—
300018235
—
IN
Enumeration date
05/07/2018
Last updated
02/20/2019
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