Individual
DR. GREGORY ROBERT WAITKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
610 MAIN ST, LAFAYETTE, IN 47901-1451
(765) 428-2242
Mailing address
610 MAIN ST, LAFAYETTE, IN 47901-1451
(765) 428-2242
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042646A
IN
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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