| Michiana Psychological Associates | |
|
323 West 4th Street Mishawaka IN 46544-1913 | |
| (574) 256-2258 | |
| (574) 256-2266 |
| Full Name | Michiana Psychological Associates |
|---|---|
| Speciality | Psychologist |
| Location | 323 West 4th Street, Mishawaka, Indiana |
| Authorized Official Name and Position | Michael L Rupley (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5742562258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michiana Psychological Associates 323 West 4th Street Mishawaka IN 46544-1913 Ph: (574) 256-2258 | Michiana Psychological Associates 323 West 4th Street Mishawaka IN 46544-1913 Ph: (574) 256-2258 |
| NPI Number | 1679741235 |
|---|---|
| Provider Enumeration Date | 02/18/2008 |
| Last Update Date | 05/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679741235 | NPI | - | NPPES |
| 000000214616 | Other | IN | ANTHEM BLUE CROSS |
| 100089740 | Medicaid | IN | |
| 100089740A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 20010350 (Indiana) | Primary |
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