Individual
NANCY WONACOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
1443 CORPORATE WAY, SEYMOUR, IN 47274
(812) 522-4341
(812) 522-7910
Mailing address
1 KALISA WAY STE 101, PARAMUS, NJ 07652-3508
(888) 948-6789
(877) 345-3501
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041777A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209033
ANTHEM PIN
IN
05
—
200401020A
—
IN
Enumeration date
02/02/2006
Last updated
07/28/2022
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