Individual
VANESSA ANN GORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
832 E NORTH ST, GREENSBURG, IN 47240-2207
(812) 560-2783
Mailing address
832 E NORTH ST, GREENSBURG, IN 47240-2207
(812) 560-2783
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003090A
IN
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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