Individual
HILLARY DEE DECKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 353-3343
(812) 353-3346
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540355
MEDICARE
IN
05
—
300013734
—
IN
Enumeration date
09/07/2017
Last updated
01/04/2023
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