Individual
DAN J RECORD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
8404 SIEAR TER, INDIANAPOLIS, IN 46227-7215
(317) 887-7050
Mailing address
8180 CLEARVISTA PKWY, 230, INDIANAPOLIS, IN 46256-5629
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003910A
IN
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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