Individual
MICHELLE DERMODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-4527
(219) 836-6752
Mailing address
7506 KIL CT, SCHERERVILLE, IN 46375-3439
(219) 864-8304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000080A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32000080A
COTA
IN
Enumeration date
07/10/2007
Last updated
05/24/2018
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