Individual
AVA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4072 SAWYER ST, INDIANAPOLIS, IN 46226-4953
(317) 607-3812
Mailing address
4072 SAWYER ST, INDIANAPOLIS, IN 46226-4953
(317) 607-3812
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-1441860-
—
IN
Enumeration date
07/05/2019
Last updated
11/30/2022
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