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JILL E SALEM PH.D., HSPP

Clinical Neuropsychologist

Lafayette, Indiana

Provider NPI: 1104908706

Provider Information:
 JILL E SALEM PH.D., HSPP
Gender: F
Not Sole Proprietor

Practice Location:
1415 SALEM ST SUITE 102 LAFAYETTE, IN 47904 US
Tel: 765-742-1816  Fax: 765-742-2557

Business Mailing Address:
1607 RAVINIA RD  WEST LAFAYETTE, IN 47906 US
Tel: 765-742-1826  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IN20041615A

Other Provider Identifiers:

IssuerNumberStateType
200283590AIN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS IN - Page 1



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