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NPI Code Detail

MEDICARE: AMBER JEANETTE MINIARD

MEDICARE: AMBER JEANETTE MINIARD
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1235069634
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER JEANETTE MINIARD
Provider Business Mailing Address
First Line : 6745 POPLAR GROVE RD
Second Line :
City : FREETOWN
State : IN
Zip : 47235-9670
Country : US
Telephone Number : 317-941-0323
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E 42ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2004
Country : US
Telephone Number : 317-493-0286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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Directions to “ AMBER JEANETTE MINIARD ” Practice Location

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