Provider Demographics
NPI:1588877492
Name:KNOUSE, ANNE ELIZABETH (OTR)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:KNOUSE
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 1:5709 DANBURY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-6047
Mailing Address - Country:US
Mailing Address - Phone:574-286-3808
Mailing Address - Fax:
Practice Address - Street 1:5709 DANBURY DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-6047
Practice Address - Country:US
Practice Address - Phone:574-286-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000424A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist