| NPI | 1750599981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANFORD LLOYD PEDERSON President 317-889-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0200X Psychologist, Forensic | |
| 103TH0004X Psychologist, Health | |
| 103TH0100X Psychologist, Health Service | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-03-19 |