Mabanta, Victoria Jean

Mabanta, Victoria Jean is an individual health care provider with primary practice located at 6011 E Hanna Ave Ste M , Indianapolis IN 46203-7115. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Mabanta, Victoria Jean can be contacted via phone (317) 787-3375.

Contact Information

Primary practice address
6011 E Hanna Ave Ste M Indianapolis IN 46203-7115
Phone: (317) 787-3375
Fax: (317) 787-3376
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 31002307A Indiana

Profile Details

NPI number 1265596241
LBN Legal business name Mabanta, Victoria Jean
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265596241 NPPES
Other 11643050 CAQH

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