| Bloomington Neurofeedback | |
|
1905 S Liberty Dr Bloomington IN 47403-5146 | |
| (812) 668-6220 | |
| (812) 668-6225 |
| Full Name | Bloomington Neurofeedback |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1905 S Liberty Dr, Bloomington, Indiana |
| Authorized Official Name and Position | Rhonda Souder (OWNER) |
| Authorized Official Contact | 5022320405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomington Neurofeedback 1905 S Liberty Dr Bloomington IN 47403-5146 Ph: (812) 688-6220 | Bloomington Neurofeedback 1905 S Liberty Dr Bloomington IN 47403-5146 Ph: (812) 668-6220 |
| NPI Number | 1710585997 |
|---|---|
| Provider Enumeration Date | 10/11/2020 |
| Last Update Date | 10/11/2020 |
| Certification Date | 10/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710585997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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