Healthcare Provider Details

I. General information

NPI: 1235508383
Provider Name (Legal Business Name): INDYA WARR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 OXON HILL RD STE 102
OXON HILL MD
20745-3166
US

IV. Provider business mailing address

14523 DELCASTLE DR
BOWIE MD
20721-3208
US

V. Phone/Fax

Practice location:
  • Phone: 240-493-7790
  • Fax:
Mailing address:
  • Phone: 301-531-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25631
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: