Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 20040062A | IN |
NPI | 1356349898 |
---|---|
Provider Name | James M Rice |
First Address | Fishers, IN 46038-4092 |
Second Address | Fishers, IN 46038-4092 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R76765 | (02) | IN |