Individual
MITCHELL JAMES VANSUMEREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
10291 N MERIDIAN ST STE 310, INDIANAPOLIS, IN 46290
(317) 672-1970
Mailing address
10291 N MERIDIAN ST STE 310, INDIANAPOLIS, IN 46290-1083
(317) 672-1970
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043294A
IN
Other
Enumeration date
08/14/2017
Last updated
09/27/2019
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