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Organization

PSYCH CONSULTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS MICHAEL ALLEN PSYD, HSPP (CLINICAL PSYCHOLOGIST)
(219) 898-5645
Entity
Organization

Contact information

Practice address
316 LINCOLNWAY, LA PORTE, IN 46350-2413
(219) 898-5645
(219) 325-0855
Mailing address
316 LINCOLNWAY, LA PORTE, IN 46350-2413
(219) 898-5645
(219) 325-0855

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042166A
IN

Other

Enumeration date
03/30/2012
Last updated
03/30/2012
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