Individual
KALYANI GOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7725 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-4731
(219) 736-1000
(219) 736-9699
Mailing address
7725 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-4731
(219) 736-1000
(219) 736-9699
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200149570A
—
IN
Enumeration date
04/25/2006
Last updated
11/19/2015
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