MEDICARE: DR. COLLEEN WASEMANN OTD, MS, OTR, CLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	31003434A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588738231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLEEN WASEMANN OTD, MS, OTR, CLC

Provider Business Mailing Address
First Line	:	14701 CUMBERLAND RD STE 300
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4374
Country	:	US
Telephone Number	:	317-753-0930
Fax Number	:	317-284-1559

Provider Business Practice Location Address
First Line	:	14701 CUMBERLAND RD STE 300
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4374
Country	:	US
Telephone Number	:	317-284-1166
Fax Number	:	317-284-1559

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	05/11/2026

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