Organization
THOMAS E HOLSWORTH
Active
Other names
Center for Psychological
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA M UMALI PSYD HSPP (OWNER)
(812) 481-9988
Entity
Organization
Contact information
Practice address
4201 MANNHEIM RD, SUITE G, JASPER, IN 47546-9617
(812) 481-9988
(812) 481-9989
Mailing address
4201 MANNHEIM RD, SUITE G, JASPER, IN 47546-9617
(812) 481-9988
(812) 481-9989
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20090206
IN
103TC0700X
Clinical Psychologist
20090206
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100109690A
—
IN
05
—
100383740A
—
IN
05
—
200463500A
—
IN
05
—
200463710A
—
IN
Enumeration date
02/20/2008
Last updated
07/09/2008
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