Individual
ASIA NICOLE DEBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9156 GRANVILLE CT, INDIANAPOLIS, IN 46229-2042
(317) 993-4064
Mailing address
9156 GRANVILLE CT, INDIANAPOLIS, IN 46229-2042
(317) 993-4064
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
014956
IN
Other
Enumeration date
08/19/2022
Last updated
11/28/2022
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