Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 28214833A | IN |
NPI | 1437722683 |
---|---|
Provider Name | April Lynette Dralle |
First Address | Bloomington, IN 47403-2208 |
Second Address | Bloomington, IN 47403-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2021 |
Last Update Date | 23/07/2021 |