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Individual

AMY BURBAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
11232 WOODS BAY LN, INDIANAPOLIS, IN 46236-7601
(317) 826-1082
Mailing address
11232 WOODS BAY LN, INDIANAPOLIS, IN 46236-7601
(317) 826-1082

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041902A
IN
103TF0000X
Family Psychologist
20041902A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200953890
IN
Enumeration date
12/11/2008
Last updated
12/26/2023
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