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General NPI Number Information
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NPI Number | 1639914112
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Entity Type | Individual
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Provider Name | REGINA ROSE GEGNER OTD, OTR/L, CEES
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Gender | Female
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 4139 VIVA LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-1913
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Country | US
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Telephone | 330-957-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 4139 VIVA LANE
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City | INDIANAPOLIS
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State | IN
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Zip | 46239
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XE1200X
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Taxonomy Name | Ergonomics Occupational Therapist
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31007873A
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License Number State | IN
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