Individual
MRS. DIANE IRENE BOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5356 LANDRUM DRIVE, INDIANAPOLIS, IN 46234
(314) 477-3714
Mailing address
5356 LANDRUM DR, INDIANAPOLIS, IN 46234-3765
(314) 477-3714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003242A
IN
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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