Davisson, Antoinette

Davisson, Antoinette is an sole proprietor health care provider with primary practice located at 2601 Ferry St , Lafayette IN 47904-3061. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Davisson, Antoinette can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2601 Ferry St Lafayette IN 47904-3061
Phone: (765) 448-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT8867 California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 31002295A Indiana

Profile Details

NPI number 1407996440
LBN Legal business name Davisson, Antoinette
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2007
Last updated May 20th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407996440 NPPES
Indiana Other 000000604008 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 200328240 ANTHEM PROVIDER NUMBER

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