Individual
JULIE KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
6031 HILLSIDE AVENUE WEST DR, INDIANAPOLIS, IN 46220-2419
(317) 319-6027
Mailing address
6031 HILLSIDE AVENUE WEST DR, INDIANAPOLIS, IN 46220-2419
(317) 319-6027
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33005347A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270296275
—
IN
Enumeration date
06/03/2009
Last updated
06/03/2009
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