Tina Povaleri
Individual provider Active NPI Developmental Therapist · Deputy, IN
NPI 1508320938 · NPPES record last updated Feb 4, 2019
Key facts
- NPI
- 1508320938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 3841 N Home Ave
Deputy, IN 47230-9080 - Phone
- (812) 599-2328
- NPI assigned
- Jan 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | IN | Yes |
Addresses
Primary practice location
3841 N Home Ave
Deputy, IN 47230-9080
Mailing address
3841 N Home Ave
Deputy, IN 47230-9080
Other providers in Deputy, IN
All providers in Deputy, IN · Developmental Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.