Provider Demographics
NPI:1164181095
Name:FU, YUMENG (OTR)
Entity Type:Individual
Prefix:
First Name:YUMENG
Middle Name:
Last Name:FU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ELLA
Other - Middle Name:
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:13426 DISTRICT PKWY UNIT 308
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7754
Mailing Address - Country:US
Mailing Address - Phone:463-710-6934
Mailing Address - Fax:
Practice Address - Street 1:13426 DISTRICT PKWY UNIT 308
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7754
Practice Address - Country:US
Practice Address - Phone:463-710-6934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007591A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty