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DR. ODIE L BRACY PHD

Clinical Neuropsychologist

Indianapolis, Indiana

Provider NPI: 1285639476

Provider Information:
DR. ODIE L BRACY PHD
Gender: M
Not Sole Proprietor

Practice Location:
6555 CARROLLTON AVE  INDIANAPOLIS, IN 46220 US
Tel: 317-257-9672  Fax: 317-257-9674

Business Mailing Address:
6555 CARROLLTON AVE  INDIANAPOLIS, IN 46220 US
Tel: 317-257-9672  Fax: 317-257-9674

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IN20010368A

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM BC/BS000000085922IN01
100073260IN05
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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