Individual
DEIDRA DOLLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6111 OLD MILL DR, INDIANAPOLIS, IN 46221-4635
(765) 644-0500
Mailing address
6111 OLD MILL DR, INDIANAPOLIS, IN 46221-4635
(765) 644-0500
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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