Individual
OLGA MANGUSHEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9919 TOWNE RD, CARMEL, IN 46032-8260
(317) 872-4166
Mailing address
9919 TOWNE RD, CARMEL, IN 46032-8260
(317) 872-4166
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005231A
IN
Other
Enumeration date
01/02/2012
Last updated
01/02/2012
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