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Individual

MRS. ANGELA LUNCEFORD WREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
521 ANTHONY ST, GREENCASTLE, IN 46135-7321
(765) 653-9405
Mailing address
521 ANTHONY STREET, GREENCASTLE, IN 46135
(765) 653-9405

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002402A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31002402A
STATE LICENSING BOARD
IN
Enumeration date
09/14/2010
Last updated
09/14/2010
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