Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 39001528A | IN |
Y | 103TC1900X | Counseling Psychologist | 39001528A | IN |
NPI | 1023425618 |
---|---|
Provider Name | Dr. Scott Eric Bischoff |
First Address | Muncie, IN 47304-5337 |
Second Address | Muncie, IN 47304-5337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 16/07/2014 |