Individual
KATELYN DIANE BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCGC
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-3966
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
74000100A
IN
170300000X
Genetic Counselor (M.S.)
Primary
74000100A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025598
—
IN
Enumeration date
11/05/2015
Last updated
07/05/2022
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