Individual
HALEY MARANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2125 16TH ST, BEDFORD, IN 47421-3003
(812) 275-4053
Mailing address
2125 16TH ST, BEDFORD, IN 47421-3003
(812) 275-4053
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001652A
IN
101YM0800X
Mental Health Counselor
Primary
39003610A
IN
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/20/2017
Last updated
11/16/2022
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