Organization
BLOOMINGTON NEUROFEEDBACK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA SOUDER LMHC (OWNER)
(502) 232-0405
Entity
Organization
Contact information
Practice address
1905 S LIBERTY DR, BLOOMINGTON, IN 47403-5146
(812) 668-6220
(812) 668-6225
Mailing address
1905 S LIBERTY DR, BLOOMINGTON, IN 47403-5146
(812) 688-6220
(812) 668-6225
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/11/2020
Last updated
10/11/2020
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