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Organization

AGELESS MINDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
QUEELA TADOUM NP (OWNER)
(317) 930-1557
Entity
Organization

Contact information

Practice address
9165 OTIS AVE STE 164, INDIANAPOLIS, IN 46216-2312
(317) 930-1557
Mailing address
9165 OTIS AVE STE 164, INDIANAPOLIS, IN 46216-2312

Taxonomy

Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary

Other

Enumeration date
04/10/2026
Last updated
04/10/2026
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