| NPI | 1750599981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANFORD LLOYD PEDERSON President 317-889-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TF0200X Psychologist Forensic | |
| 103TH0004X Psychologist Health | |
| 103TH0100X Psychologist Health Service | |
| 103TR0400X Psychologist Rehabilitation | |
| 103G00000X Clinical Neuropsychologist | |
| 103TA0700X Psychologist Adult Development & Aging | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2024-06-07 |