Individual
ETHAN OBENAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS/CAS
Contact information
Practice address
PO BOX 508, NEW PALESTINE, IN 46163-0508
(317) 861-4463
Mailing address
PO BOX 508, NEW PALESTINE, IN 46163-0508
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
15083667
IN
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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