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Individual

SHARYL A ALTUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
HSPP

Contact information

Practice address
427 W EADS PKWY, LAWRENCEBURG, IN 47025-1139
(812) 537-7375
Mailing address
285 BIELBY RD, LAWRENCEBURG, IN 47025-1055
(812) 537-1302

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041835A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000255683
BLUE SHIELD
IN
Enumeration date
01/12/2007
Last updated
07/09/2007
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