Individual
ERICA L FAANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
503 OTIS BOWEN DR, MUNSTER, IN 46321-4158
(219) 934-0590
Mailing address
503 OTIS BOWEN DR, MUNSTER, IN 46321-4158
(219) 934-0590
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056012935
IL
225X00000X
Occupational Therapist
Primary
31007561A
IN
Other
Enumeration date
04/26/2019
Last updated
09/12/2023
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