Individual
REBECCA LEANN BOTTOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 W. 16TH STREET, DEPT. OF PSYCHIATRY, INDIANAPOLIS, IN 46202-2207
(317) 963-7288
(317) 963-7313
Mailing address
250 N SHADELAND AVE, SUITE 200 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 962-4942
(317) 962-4343
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01078932A
IN
390200000X
Student in an Organized Health Care Education/Training Program
192262
NC
Other
Enumeration date
05/22/2013
Last updated
07/21/2022
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