Individual
DR. ALISA JILL FAUST-HALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
6060 N COLLEGE AVE, INDIANAPOLIS, IN 46220-1907
(317) 254-3317
(317) 726-0257
Mailing address
6060 N COLLEGE AVE, INDIANAPOLIS, IN 46220-1907
(317) 254-3317
(317) 726-0257
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041879A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200460920
—
IN
Enumeration date
09/20/2006
Last updated
02/26/2013
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