Provider Demographics
NPI:1316599285
Name:WITT, CLAUDIA LEE (PTA)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:LEE
Last Name:WITT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6100
Mailing Address - Country:US
Mailing Address - Phone:219-405-2027
Mailing Address - Fax:
Practice Address - Street 1:6600 MILLER AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46403-2571
Practice Address - Country:US
Practice Address - Phone:219-427-0196
Practice Address - Fax:219-427-0197
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06005570A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN06005570AOtherPTA