Individual
MRS. KATHERINE GRACE SPOONAMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1800 N CAPITOL AVE, INDIANAPOLIS, IN 46202-1218
(317) 962-0511
Mailing address
1800 N CAPITOL AVE, INDIANAPOLIS, IN 46202-1218
(317) 962-0511
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
74000056A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999999999
—
IN
Enumeration date
06/11/2012
Last updated
10/22/2014
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