GWEN C SPREHN PHD
Clinical Neuropsychologist
Indianapolis, Indiana
Provider NPI: 1255327748
Provider Information:GWEN C SPREHN PHD
Gender: F
Not Sole Proprietor
Practice Location:
DEPT OF NEUROLOGY INDIANA UNIVERSITY SCHOOL OF MED 541 CLINICAL DRIVE (CL-299) INDIANAPOLIS, IN 46202 US
Tel: 317-274-7327 Fax: --
Business Mailing Address:
250 N SHADELAND AVE STE 130 - PROVIDER ENROLLMENT INDIANAPOLIS, IN 46219 US
Tel: -- Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | IN | 20042146A |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
200856010 | IN | 05 |
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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