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7739 E 88th St Indianapolis IN 46256-1231 | |
| (317) 517-8817 | |
| (888) 443-4046 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 7739 E 88th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Momi Yamanaka (OWNER) |
| Authorized Official Contact | 3175178817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1064 Carmel IN 46082-1064 Ph: (317) 517-8817 | 7739 E 88th St Indianapolis IN 46256-1231 Ph: (317) 517-8817 |
| NPI Number | 1609231992 |
|---|---|
| Provider Enumeration Date | 12/31/2015 |
| Last Update Date | 12/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609231992 | NPI | - | NPPES |
| 200913370A | Medicaid | IN |
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