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Individual

DR. MICHELE JANINE BOBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
4607 N WHEELING AVE, MUNCIE, IN 47304-1220
(765) 288-1110
(765) 288-4044
Mailing address
715 N BITTERSWEET LN, MUNCIE, IN 47304-3754
(765) 286-8788
(765) 288-4044

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041822A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000316087
ANTHEM BCBS
IN
05
200451310
IN
01
500867
VALUE OPTIONS
IN
01
708119000
MAGELLAN
IN
Enumeration date
11/01/2006
Last updated
07/08/2007
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