Individual
ACHILLES DOMINIC ANGELICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
11186 AVILA WAY, FISHERS, IN 46038-4628
(317) 514-8462
Mailing address
11186 AVILA WAY, FISHERS, IN 46038-4628
(317) 514-8462
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009251A
IN
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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