Individual
ELISE HOPE BASILETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DSP
Contact information
Practice address
2 N MERIDIAN ST, INDIANAPOLIS, IN 46204-3021
(317) 232-7349
Mailing address
60 MULBERRY CT, LAFAYETTE, IN 47905-3934
(765) 409-1829
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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