Individual
PAULA MICHELLE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, HSPP
Contact information
Practice address
3209 W. SMITH VALLEY RD., #231, GREENWOOD, IN 46142-8511
(317) 801-1218
(317) 884-5518
Mailing address
3209 W. SMITH VALLEY RD., #231, GREENWOOD, IN 46142-8511
(317) 801-1218
(317) 884-5518
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041719A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225455
ANTHEM
IN
05
—
200408260A
—
IN
01
—
277180000
MAGELLAN
IN
Enumeration date
10/25/2005
Last updated
11/07/2019
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