Individual
RITA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2707 RAND RD, INDIANAPOLIS, IN 46241-5504
(317) 672-2621
Mailing address
2707 RAND RD, INDIANAPOLIS, IN 46241-5504
(317) 672-2621
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001406A
IN
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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