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Individual

MRS. LINA MARIO PULIDO-RAMIREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
17840 CUMBERLAND RD, NOBLESVILLE, IN 46060-5409
(317) 574-1254
(317) 674-0060
Mailing address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0500

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
34006696A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000839292
ANTHEM
IN
01
527078
MHN/TRICARE
IN
01
P01303019
MEDICARE RAILROAD
IN
Enumeration date
05/01/2007
Last updated
07/10/2014
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