Organization
MAHAN AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUELLYN MAHAN PH.D (OWNER)
(812) 236-9569
Entity
Organization
Contact information
Practice address
1400 E PUGH DR, SUITE 3, TERRE HAUTE, IN 47802-3942
(812) 236-9569
(812) 237-3964
Mailing address
1400 E PUGH DR, SUITE 3, TERRE HAUTE, IN 47802-3942
(812) 236-9569
(812) 237-3964
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20041149
IN
103TC2200X
Clinical Child & Adolescent Psychologist
20041149
IN
103TS0200X
School Psychologist
Primary
20041149
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200927070
—
IN
Enumeration date
06/11/2007
Last updated
07/30/2010
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