Individual
SAMANTHA ANN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11570 E 126TH ST, FISHERS, IN 46037-9592
(317) 579-0166
Mailing address
2465 BROADWAY ST, INDIANAPOLIS, IN 46205-4551
(419) 969-4420
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005299A
IN
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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