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Individual

DR. CATHERINE ELIZABETH BUCKINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD HSPP

Contact information

Practice address
7250 CLEARVISTA DRIVE, SUITE 227, INDIANAPOLIS, IN 46256-5600
(317) 621-7804
(317) 621-7275
Mailing address
6626 E 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040938A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200324030
IN
01
P01191790
RR MEDICARE PTAN
IN
01
P01678706
RR MEDICARE
IN
Enumeration date
09/21/2005
Last updated
11/27/2023
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