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DR. CORBY ALAN BUBP PH.D.

Clinical Neuropsychologist

Indianapolis, Indiana

Provider NPI: 1134136229

Provider Information:
DR. CORBY ALAN BUBP PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
10293 N MERIDIAN ST  INDIANAPOLIS, IN 46290 US
Tel: 317-581-2288  Fax: 317-581-2295

Business Mailing Address:
10291 N MERIDIAN ST STE 310 INDIANAPOLIS, IN 46290 US
Tel: 317-581-2288  Fax: 317-581-2295

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IN20042024

Other Provider Identifiers:

IssuerNumberStateType
200504340IN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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