Individual
MR. TADD MICHAEL WHALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAC
Contact information
Practice address
515 N GREEN ST, STE 402, BROWNSBURG, IN 46112-2421
(317) 852-3690
Mailing address
10889 PARKER DR, INDIANAPOLIS, IN 46231-1077
(317) 313-0448
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000325A
IN
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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