Provider Demographics
NPI:1235508383
Name:WARR, INDYA
Entity Type:Individual
Prefix:
First Name:INDYA
Middle Name:
Last Name:WARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 BASKERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2405
Mailing Address - Country:US
Mailing Address - Phone:301-512-6412
Mailing Address - Fax:
Practice Address - Street 1:4467 OLD BRANCH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1854
Practice Address - Country:US
Practice Address - Phone:301-358-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist