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General NPI Number Information
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NPI Number | 1992429807
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Entity Type | Organization
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Legal Business Name | LIFE AMPLIFIED OCCUPATIONAL THERAPY, LLC
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 7946 ALAMOSA LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46236-6527
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Country | US
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Telephone | 317-657-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 7946 ALAMOSA LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46236-6527
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Country | US
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Telephone | 317-657-7790
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ELIZABETH MCWILLIAMS
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Credential | MS, OTR
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Telephone | 317-343-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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