| Indiana Telepsych Np, Llc | |
|
1246 E Marigold Dr Bloomington IN 47401-8983 | |
| (812) 599-4138 | |
| Not Available |
| Full Name | Indiana Telepsych Np, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1246 E Marigold Dr, Bloomington, Indiana |
| Authorized Official Name and Position | Amanda Kent (OWNER) |
| Authorized Official Contact | 8125994138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana Telepsych Np, Llc 1246 E Marigold Dr Bloomington IN 47401-8983 Ph: (812) 599-4138 | Indiana Telepsych Np, Llc 1246 E Marigold Dr Bloomington IN 47401-8983 Ph: (812) 599-4138 |
| NPI Number | 1528823697 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528823697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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