Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 20042409A | IN |
Y | 103TC0700X | Clinical Psychologist | 20042409A | IN |
N | 103TR0400X | Rehabilitation Psychologist | 20042409A | IN |
NPI | 1235392101 |
---|---|
Provider Name | Dr. Nathan M Parmer |
First Address | Chicago, IL 60677-5985 |
Second Address | Noblesville, IN 46060-1425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201007830 | (05) | IN |