Individual
ASHLEY ELIZABETH FAUCAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
601 SHEFFIELD AVE, DYER, IN 46311-1167
(219) 322-2273
Mailing address
9035 HESS DR, HIGHLAND, IN 46322-2132
(219) 308-8832
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003288A
IN
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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