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Individual

DOUG COLGROVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LSW

Contact information

Practice address
6745 GRAY RD, SUITE C, INDIANAPOLIS, IN 46237-3262
(317) 683-5078
(317) 782-7905
Mailing address
6745 GRAY RD, SUITE C, INDIANAPOLIS, IN 46237-3262
(317) 683-5078
(317) 782-7905

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
33003053A
IN

Other

Enumeration date
12/29/2011
Last updated
12/29/2011
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