Individual
ABIGAIL BASTNAGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 E 91ST ST STE 316, INDIANAPOLIS, IN 46240-1556
(317) 550-3221
Mailing address
50 E 91ST ST STE 316, INDIANAPOLIS, IN 46240-1556
(317) 550-3221
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043590B
IN
Other
Enumeration date
09/23/2022
Last updated
10/01/2024
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