Individual
MRS. DENISE HENRIETTE O'DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1801 PARK AVE, WINONA LAKE, IN 46590-1638
(574) 267-8160
Mailing address
1801 PARK AVE, WINONA LAKE, IN 46590-1638
(574) 267-8160
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002338A
IN
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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