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Individual

SHELVY HAYWOOD KEGLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
525 E 38TH ST, INDIANAPOLIS, IN 46205-2744
(317) 923-3930
(317) 923-2441
Mailing address
525 E 38TH ST, INDIANAPOLIS, IN 46205-2744
(317) 923-3930
(317) 923-2441

Taxonomy

Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
20040520A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000183364
ANTHEM
IN
05
100235970A
IN
Enumeration date
01/10/2007
Last updated
01/11/2021
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