Individual
MRS. DIANE BETH PENNYCUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
637 S STATE ROAD 135, SUITE C, GREENWOOD, IN 46142-1443
(317) 865-1110
(317) 865-0221
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001630A
IN
Other
Enumeration date
05/15/2008
Last updated
02/15/2022
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