Organization
LOUISE MIRACLE, PHD, HSPP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUISE MIRACLE PH.D., HSPP (PSYCHOLOGIST/PRESIDENT)
(812) 339-4877
Entity
Organization
Contact information
Practice address
2525 W. VERNAL PIKE, BLOOMINGTON, IN 47404
(812) 339-4877
(812) 339-4877
Mailing address
P.O. BOX 3155, BLOOMINGTON, IN 47402
(812) 339-4877
(812) 339-4877
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040642A
IN
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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