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Individual

MARY LOU WULF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
1701 N SENATE BLVD, RM AG 001, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 962-8652
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
70000209
IN
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
70000209A
IN

Other

Enumeration date
06/25/2008
Last updated
03/08/2021
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