Organization
KIDPSYCH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARA E DAVIS PH, D HSPP (OWNER)
(540) 446-9805
Entity
Organization
Contact information
Practice address
21444 ANTHONY RD, NOBLESVILLE, IN 46062-8277
(540) 446-9805
(317) 758-5850
Mailing address
21444 ANTHONY RD, NOBLESVILLE, IN 46062-8277
(540) 446-9805
(317) 758-5850
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
VA0810003385
IN
235Z00000X
Speech-Language Pathologist
Primary
2204584A
IN
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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