Organization
LIBERTAD COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZANNE RAE BAUTISTA NCACII (CLINICAL DIRECTOR)
(317) 240-2801
Entity
Organization
Contact information
Practice address
5230 W 10TH ST, INDIANAPOLIS, IN 46224-6906
(317) 240-2801
Mailing address
5320 W. 10TH STREET, INDIANAPOLIS, IN 46224-6306
(317) 240-2801
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C973
IN
Other
Enumeration date
04/01/2009
Last updated
04/01/2009
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