Organization
INDIANA EVALUATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY LYNN O'CONNOR LSW (PRESIDENT)
(812) 333-1706
Entity
Organization
Contact information
Practice address
2633 E DEKIST ST, BLOOMINGTON, IN 47408-4216
(812) 333-1706
(812) 336-3283
Mailing address
2633 DEKIST STREET, BLOOMINGTON, IN 47408-4216
(812) 333-1766
(812) 336-8232
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
20041846
IN
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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