Individual
KIEANA DYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1232 N LAYMAN AVE, INDIANAPOLIS, IN 46219-3106
(317) 403-7406
Mailing address
1232 N LAYMAN AVE, INDIANAPOLIS, IN 46219-3106
(317) 403-7406
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
000000000
IN
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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