Provider Demographics
NPI:1558976688
Name:FORRER, GRETA
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:FORRER
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 1:28333 N DUCK CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:IN
Mailing Address - Zip Code:46031-9747
Mailing Address - Country:US
Mailing Address - Phone:317-385-5101
Mailing Address - Fax:
Practice Address - Street 1:6330 E 75TH ST STE 206
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2700
Practice Address - Country:US
Practice Address - Phone:317-284-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist