Organization
MODERN DAY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA COOLEY MSW, LSW (EXECUTIVE DIRECTOR/FOUNDER)
(317) 908-6063
Entity
Organization
Contact information
Practice address
3675 WASHINGTON BLVD, INDIANAPOLIS, IN 46205-3533
(317) 908-6063
Mailing address
3675 WASHINGTON BLVD, INDIANAPOLIS, IN 46205-3533
(317) 908-6063
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006192A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201225250 A
—
IN
Enumeration date
04/01/2014
Last updated
06/18/2014
About Stedi
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