Basic Information
Provider Information
NPI: 1245898519
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KESSLER
FirstName: ANNA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1701 LIBRARY BLVD STE A
Address2:  
City: GREENWOOD
State: IN
PostalCode: 461421567
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1701 LIBRARY BLVD STE A
Address2:  
City: GREENWOOD
State: IN
PostalCode: 461421567
CountryCode: US
TelephoneNumber: 3178819923
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2019
LastUpdateDate: 06/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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