Provider Demographics
NPI:1083368062
Name:FLORICH-BROWN, ANNE-MARIE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:FLORICH-BROWN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 EXECUTIVE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4881
Mailing Address - Country:US
Mailing Address - Phone:765-446-8300
Mailing Address - Fax:
Practice Address - Street 1:35 EXECUTIVE DR STE 5
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4881
Practice Address - Country:US
Practice Address - Phone:765-446-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006741A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist