Individual
LINN SUSAN LACLAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
702 BARNHILL DR, INDIANAPOLIS, IN 46202-5128
(317) 274-3960
Mailing address
550 N MERIDIAN ST, STE 114, INDIANAPOLIS, IN 46204-1207
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040045
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200061060
—
IN
Enumeration date
05/19/2006
Last updated
07/05/2022
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