Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 20041894A | IN |
NPI | 1114954062 |
---|---|
Provider Name | Robyn Kittrell |
First Address | Muncie, IN 47304-2264 |
Second Address | Muncie, IN 47304-2264 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 06/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000030791 | MPLAN (01) | IN |
000000363649 | ANTHEM BCBS (01) | IN |
740327000 | MAGELLAN HEALTH SERVICES (01) | IN |