Individual
DR. JONATHAN DALE NEUFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042056A
IN
103TC0700X
Clinical Psychologist
PSY17420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200804500A
—
IN
05
—
200888680
—
IN
Enumeration date
03/09/2006
Last updated
01/07/2016
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