Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003061524 |
---|---|
Provider Name | Molly Tompkins |
First Address | Noblesville, IN 46060-5614 |
Second Address | Indianapolis, IN 46205-2380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2008 |
Last Update Date | 25/11/2008 |