Provider Demographics
NPI:1245440452
Name:VAN VLEET, BARBARA RUTH (DT, RN)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RUTH
Last Name:VAN VLEET
Suffix:
Gender:F
Credentials:DT, RN
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Mailing Address - Street 1:11213 BAYRIDGE CIR E
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-8731
Mailing Address - Country:US
Mailing Address - Phone:317-513-1517
Mailing Address - Fax:317-826-0606
Practice Address - Street 1:11213 BAYRIDGE CIR E
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-8731
Practice Address - Country:US
Practice Address - Phone:317-513-1517
Practice Address - Fax:317-826-0606
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28145183A163WP0200X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist