Individual
MARCIA DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
5922 SYCAMORE FORGE CT, INDIANAPOLIS, IN 46254-1277
(317) 340-3833
Mailing address
5922 SYCAMORE FORGE CT, INDIANAPOLIS, IN 46254-1277
(317) 340-3833
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530A
—
IN
Enumeration date
06/19/2006
Last updated
04/02/2012
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