Individual
ELIZABETH DESONIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
950 CROSS AVE, MADISON, IN 47250-2002
(812) 273-4640
Mailing address
109 PARKVIEW DR, MADISON, IN 47250-2930
(812) 290-6528
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
32003560A
IN
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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