Organization
INDIANA TELEPSYCH NP, LLC
Active
Other names
Indiana TelePsych NP, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA KENT PMHNP-BC (OWNER)
(812) 599-4138
Entity
Organization
Contact information
Practice address
1246 E MARIGOLD DR, BLOOMINGTON, IN 47401-8983
(812) 599-4138
Mailing address
1246 E MARIGOLD DR, BLOOMINGTON, IN 47401-8983
(812) 599-4138
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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