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Organization

GARY M. DURAK, PH.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY M. DURAK PH.D. (CLINICAL PSYCHOLOGSIT)
(219) 464-7678
Entity
Organization

Contact information

Practice address
307 JEFFERSON ST, VALPARAISO, IN 46383-4823
(219) 464-7678
(219) 462-8351
Mailing address
307 JEFFERSON ST, VALPARAISO, IN 46383-4823
(219) 464-7678
(219) 462-8351

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20090233A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100298960A
IN
Enumeration date
10/07/2008
Last updated
09/24/2009
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