| Great Lakes Institute For Neuropsychology & Behavioral Health | |
|
494 S Emerson Ave Suite C Greenwood IN 46143-1912 | |
| (317) 889-3901 | |
| (317) 889-3902 |
| Full Name | Great Lakes Institute For Neuropsychology & Behavioral Health |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 494 S Emerson Ave, Greenwood, Indiana |
| Authorized Official Name and Position | Sanford Lloyd Pederson (PRESIDENT) |
| Authorized Official Contact | 3178893901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Institute For Neuropsychology & Behavioral Health Po Box 750233 Dayton OH 45475-0233 Ph: (317) 889-3901 | Great Lakes Institute For Neuropsychology & Behavioral Health 494 S Emerson Ave Suite C Greenwood IN 46143-1912 Ph: (317) 889-3901 |
| NPI Number | 1750599981 |
|---|---|
| Provider Enumeration Date | 05/20/2007 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750599981 | NPI | - | NPPES |
| 200227370 | Medicaid | IN |
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