Individual provider · Type 1 NPI

Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS

Occupational Therapist · East Chicago, IN

NPI number 1891285748 Active

Practice location

4321 Fir St
East Chicago, IN 46312-3097

Call (219) 392-7400 Map

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000X31005709A (IN)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1891285748

Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS's National Provider Identifier is 1891285748, issued on May 16, 2018. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in East Chicago, IN. The record was last updated on May 16, 2018.