Individual
ROSEMARY HALE SURACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
611 E 10TH ST, SHERIDAN, IN 46069-9106
(317) 758-4477
Mailing address
PO BOX 843022, KANSAS CITY, MO 64184-3022
(317) 770-6900
(317) 770-6911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043509A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300054533
—
IN
Enumeration date
06/26/2019
Last updated
04/23/2025
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