Organization
HEDGEHOG PSYCHIATRIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PENNI FUQUA (PRESIDENT/OWNER)
(317) 337-9967
Entity
Organization
Contact information
Practice address
8563 ZIONSVILLE RD, INDIANAPOLIS, IN 46268-1511
(317) 337-9967
(317) 337-9968
Mailing address
8563 ZIONSVILLE RD, INDIANAPOLIS, IN 46268-1511
(317) 337-9967
(317) 337-9968
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
34003324A
IN
364S00000X
Clinical Nurse Specialist
Primary
70000131A
IN
364S00000X
Clinical Nurse Specialist
71000401A
IN
Other
Enumeration date
05/22/2006
Last updated
11/19/2007
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