Individual
DIANA DERRER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
7833 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4189
(260) 432-4848
Mailing address
7434 HOPE FARM RD, FORT WAYNE, IN 46815-6540
(317) 903-7349
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31008101A
IN
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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