Individual
UDANA DALISE VERGNAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8616 W 10TH ST, INDIANAPOLIS, IN 46234-2167
(317) 209-2332
Mailing address
8616 W 10TH ST, INDIANAPOLIS, IN 46234-2167
(317) 209-2332
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
310036684A
IN
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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