Provider Demographics
NPI:1093933640
Name:LANDGREBE, KARALYN J (OTR)
Entity Type:Individual
Prefix:
First Name:KARALYN
Middle Name:J
Last Name:LANDGREBE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KARALYN
Other - Middle Name:J
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1409 N SUMAC CT
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-9376
Mailing Address - Country:US
Mailing Address - Phone:812-345-3385
Mailing Address - Fax:
Practice Address - Street 1:1409 N SUMAC CT
Practice Address - Street 2:
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429-9376
Practice Address - Country:US
Practice Address - Phone:812-345-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003496A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist