Individual
DR. NAOMI PICKHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4935 W ARLINGTON RD, BLOOMINGTON, IN 47404-1187
(812) 353-3800
(812) 353-3770
Mailing address
4935 W ARLINGTON RD, BLOOMINGTON, IN 47404-1187
(812) 353-3800
(812) 353-3770
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
20042504A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201042360
—
IN
Enumeration date
01/02/2007
Last updated
06/29/2012
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