| Wabash Valley Therapy, Llc | |
|
609 E Surgery Center Dr Terre Haute IN 47802-6815 | |
| (812) 917-5091 | |
| Not Available |
| Full Name | Wabash Valley Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 609 E Surgery Center Dr, Terre Haute, Indiana |
| Authorized Official Name and Position | Dianna Cooper-bolinskey (THERAPIST) |
| Authorized Official Contact | 8122301699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wabash Valley Therapy, Llc 30 Allendale Terre Haute IN 47802-4751 Ph: (812) 230-1699 | Wabash Valley Therapy, Llc 609 E Surgery Center Dr Terre Haute IN 47802-6815 Ph: (812) 917-5091 |
| NPI Number | 1225695745 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 05/20/2019 |
| Medicare PECOS PAC ID | 4183957574 |
|---|---|
| Medicare Enrollment ID | O20190618002116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225695745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dianna R Cooper Bolinskey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366624678 PECOS PAC ID: 2769643477 Enrollment ID: I20120405000256 |
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