Individual
THERESA JANE RADER-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD HSPP
Contact information
Practice address
8175 HENDERSON RIDGE DR, MOORESVILLE, IN 46158-7205
(317) 460-9455
Mailing address
8175 HENDERSON RIDGE DR, MOORESVILLE, IN 46158-7205
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
20041299A
IN
103TC0700X
Clinical Psychologist
Primary
20041299A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389320
—
IN
Enumeration date
11/08/2006
Last updated
03/17/2026
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