Individual
DOMINIC LETIZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
350 E NEW YORK ST STE 240, INDIANAPOLIS, IN 46204-2134
(260) 433-6950
Mailing address
350 E NEW YORK ST STE 240, INDIANAPOLIS, IN 46204-2134
(260) 433-6950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000548A
IN
103TC0700X
Clinical Psychologist
Primary
20042871A
IN
Other
Enumeration date
05/05/2014
Last updated
06/06/2016
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