Individual
MS. MARY E. HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1002 WISHARD BLVD, WISHARD PEDIATRIC PRIMARY CARE CLINIC, INDIANAPOLIS, IN 46202-2872
(317) 630-8893
(317) 692-2372
Mailing address
1002 WISHARD BLVD, PRIMARY CARE CLINIC, INDIANAPOLIS, IN 46202-2872
(317) 630-8893
(317) 692-2372
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005835A
IN
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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