| Kokomo Academy | |
|
623 S Berkley Rd Kokomo IN 46901-5150 | |
| (765) 452-9989 | |
| Not Available |
| Full Name | Kokomo Academy |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 623 S Berkley Rd, Kokomo, Indiana |
| Authorized Official Name and Position | Roger Snyder (VICE PRESIDENT) |
| Authorized Official Contact | 3172741359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kokomo Academy 900 Keystone Crossing Ste 1040 Indianapolis IN 46240 Ph: (317) 694-4074 | Kokomo Academy 623 S Berkley Rd Kokomo IN 46901-5150 Ph: (765) 452-9989 |
| NPI Number | 1043496060 |
|---|---|
| Provider Enumeration Date | 01/22/2008 |
| Last Update Date | 01/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043496060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Indiana) | Primary |
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