Individual
DR. DANA G. LASEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
420 E MAIN ST, GREENWOOD, IN 46143-1364
(317) 502-1608
Mailing address
11070 WINDING BROOK LN, INDIANAPOLIS, IN 46280-1258
(317) 502-1608
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041509A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000050018
ANTHEM BLUE CROSS BLUE SH
IN
Enumeration date
04/06/2007
Last updated
07/08/2007
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