Provider Demographics
NPI:1932695244
Name:WIELING, RICHELLE ELIZABETH (OTR)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:ELIZABETH
Last Name:WIELING
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 YARBROUGH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEBO
Mailing Address - State:KY
Mailing Address - Zip Code:42441-9103
Mailing Address - Country:US
Mailing Address - Phone:812-887-4588
Mailing Address - Fax:
Practice Address - Street 1:2920 10TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6602
Practice Address - Country:US
Practice Address - Phone:812-887-4588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006648A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist