The Villages | |
2405 N Smith Pike Bloomington IN 47404-1363 | |
(812) 332-1245 | |
(812) 333-4717 |
Full Name | The Villages |
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Speciality | Psychologist - Psychoanalysis |
Location | 2405 N Smith Pike, Bloomington, Indiana |
Authorized Official Name and Position | Kimberly J Davis (COMPLIANCE MGR) |
Authorized Official Contact | 8123321245 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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The Villages 2405 N Smith Pike Bloomington IN 47404-1363 Ph: (812) 332-1245 | The Villages 2405 N Smith Pike Bloomington IN 47404-1363 Ph: (812) 332-1245 |
NPI Number | 1558322776 |
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Provider Enumeration Date | 03/29/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558322776 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TP0814X | Psychologist - Psychoanalysis | (* (Not Available)) | Primary |
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