Individual
GREGORY CORRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9904 RIDGEWAY CT, MC CORDSVILLE, IN 46055-9790
(317) 335-3871
Mailing address
17330 W CENTER RD, SUITE 110-282, OMAHA, NE 68130-2392
(317) 446-9288
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20040294A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018970A
—
IN
Enumeration date
07/07/2005
Last updated
09/30/2009
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