Organization
LIFESPAN NEUROPSYCOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN A HUDSON PHD (OWNER/PHSYICIAN)
(317) 962-2594
Entity
Organization
Contact information
Practice address
1060 EAST 86TH ST., SUITE 63D, INDIANAPOLIS, IN 46240-1831
(317) 569-9922
(317) 962-1895
Mailing address
1427 WEST 86TH ST., SUITE 245, INDIANAPOLIS, IN 46260-2103
(317) 569-9922
(317) 962-1895
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040858A
IN
Other
Enumeration date
12/02/2008
Last updated
12/02/2008
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