Individual
AUTUM LOUGHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1618 W 3RD ST, BLOOMINGTON, IN 47404-5026
(812) 676-7000
Mailing address
1618 W 3RD ST, BLOOMINGTON, IN 47404-5026
(812) 676-7000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007992A
IN
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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