Individual
DR. DANITA LYNN LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 PRO-MED LN, CARMEL, IN 46032-5317
(317) 844-0055
(317) 581-3918
Mailing address
210 E 91ST ST, SUITE C, INDIANAPOLIS, IN 46240-1569
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01031924A
IN
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
01031924A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100352260
—
IN
Enumeration date
12/02/2005
Last updated
01/06/2020
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