Organization
LIZA R SIMENTAL, PHD HSPP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIZA R RUDOLPH PH.D. (OWNER)
(765) 532-9084
Entity
Organization
Contact information
Practice address
255 E SUNSET LN, WEST LAFAYETTE, IN 47906-2456
(765) 532-9084
(765) 447-9659
Mailing address
PO BOX 3884, WEST LAFAYETTE, IN 47996-3884
(765) 532-9084
(765) 447-9659
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
200251030
IN
Other
Enumeration date
04/08/2008
Last updated
05/05/2016
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