Individual
C HERBERT HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3838 N RURAL ST, INDIANAPOLIS, IN 46205-2930
(317) 221-2306
(317) 221-2336
Mailing address
3225 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46208-4672
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040083A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100227230
—
IN
Enumeration date
09/01/2006
Last updated
07/08/2007
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