Provider Demographics
NPI:1740759356
Name:GEARHART HOWELL, LANA RENEE (DT-B)
Entity Type:Individual
Prefix:MS
First Name:LANA
Middle Name:RENEE
Last Name:GEARHART HOWELL
Suffix:
Gender:F
Credentials:DT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 S HARRELL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-9092
Mailing Address - Country:US
Mailing Address - Phone:812-320-0055
Mailing Address - Fax:
Practice Address - Street 1:6239 S EAST ST STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2088
Practice Address - Country:US
Practice Address - Phone:812-320-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist