Individual
MRS. MARCIA A KOELNDORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
14887 STATE ROAD 23, STE 3, GRANGER, IN 46530-5629
(574) 232-2255
(574) 232-8968
Mailing address
52305 WOOD HAVEN CT, GRANGER, IN 46530-5612
(574) 387-5598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003882A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000389244
ANTHEM
IN
Enumeration date
10/13/2005
Last updated
08/23/2018
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