Provider Demographics
NPI:1992209779
Name:GRAHN, MORGAN ROSELYN (OTR)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ROSELYN
Last Name:GRAHN
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 1:5421 E PLEASANT RUN PARKWAY SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-5721
Mailing Address - Country:US
Mailing Address - Phone:765-918-3625
Mailing Address - Fax:
Practice Address - Street 1:5421 E PLEASANT RUN PARKWAY SOUTH DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-5721
Practice Address - Country:US
Practice Address - Phone:765-918-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005834A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist