Individual
DR. CHRISTINE M LIEDTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., HSPP
Contact information
Practice address
14074 TRADE CENTER DR STE 208, FISHERS, IN 46038-4574
(440) 241-5275
Mailing address
14074 TRADE CENTER DR STE 208, FISHERS, IN 46038-4574
(440) 241-5275
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042492A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201092020
—
IN
Enumeration date
11/01/2010
Last updated
03/04/2024
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