Individual
DR. SHANNON ELISABETH WOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4391
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4391
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042384A
IN
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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