Individual
ERIC LYAKHOVETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
327 W SAIDAH RD, BLOOMINGTON, IN 47404-8965
(317) 509-0451
Mailing address
327 W SAIDAH RD, BLOOMINGTON, IN 47404-8965
(317) 509-0451
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28216197A
IN
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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