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Individual

LINDA MCINTIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HSPP

Contact information

Practice address
149 W BROADWAY ST, SHELBYVILLE, IN 46176-1201
(317) 298-7211
(317) 398-7210
Mailing address
149 W BROADWAY ST, SHELBYVILLE, IN 46176-1201
(317) 398-7211
(317) 398-7210

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042156A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000321009
ANTHEM PIN
IN
Enumeration date
02/02/2006
Last updated
04/09/2009
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