Individual
CARLY WEYGANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
11496 BROADWAY, CROWN POINT, IN 46307-7106
(219) 213-2222
(847) 786-2156
Mailing address
PO BOX 416501, BOSTON, MA 02241-6501
(194) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.014784
IL
225X00000X
Occupational Therapist
Primary
31007674A
IN
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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