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3700 Washington Ave Evansville IN 47750-0001 | |
| (812) 485-4000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3700 Washington Ave, Evansville, Indiana |
| Authorized Official Name and Position | William J Millikan (CEO) |
| Authorized Official Contact | 8124854000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 13059 Belfast ME 04915-4021 Ph: (317) 583-3022 | 3700 Washington Ave Evansville IN 47750-0001 Ph: (812) 485-4000 |
| NPI Number | 1952750606 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 06/29/2020 |
| Certification Date | 06/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952750606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Indiana) | Secondary |
| 103TC0700X | Psychologist - Clinical | (Indiana) | Primary |
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