Individual
DIONNE DYNLACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
12647 GEIST COVE DR, INDIANAPOLIS, IN 46236-7239
(317) 826-4205
Mailing address
12647 GEIST COVE DR, INDIANAPOLIS, IN 46236-7239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20041360A
IN
103TB0200X
Cognitive & Behavioral Psychologist
20041360A
IN
103TC0700X
Clinical Psychologist
20041360A
IN
103TC1900X
Counseling Psychologist
20041360A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
20041360A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000849448
ANTHEM BCBS
IN
05
—
100323760A
—
IN
05
—
201057980
—
IN
Enumeration date
06/15/2006
Last updated
04/22/2021
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