Organization
BRANCHES OF LIFE FAMILY CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON M DICKERSON M.S (PRESIDENT/THERAPIST)
(317) 446-4943
Entity
Organization
Contact information
Practice address
4954 E 56TH ST, #10, INDIANAPOLIS, IN 46220-5773
(317) 449-0334
(317) 536-1070
Mailing address
4954 E 56TH ST, #10, INDIANAPOLIS, IN 46220-5773
(317) 449-0334
(317) 536-1070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/03/2009
Last updated
01/14/2010
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