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NPI Code Detail

MEDICARE: COLLEEN RENEE PEPIN

MEDICARE: COLLEEN RENEE PEPIN
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 : 1477415222
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN RENEE PEPIN
Provider Business Mailing Address
First Line : 1120 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-3286
Country : US
Telephone Number : 219-983-9675
Fax Number : 219-983-9681
Provider Business Practice Location Address
First Line : 1120 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-3286
Country : US
Telephone Number : 219-983-9675
Fax Number : 219-983-9681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ COLLEEN RENEE PEPIN ” Practice Location

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