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PAUL WARREN MACELLARI PH.D.

Clinical Neuropsychologist

Mishawaka, Indiana

Provider NPI: 1871660035

Provider Information:
 PAUL WARREN MACELLARI PH.D.
Gender: M
Sole Proprietor


Practice Location:
135 RED COACH DR  MISHAWAKA, IN 46545 US
Tel: 574-254-9200  Fax: 574-254-9202

Business Mailing Address:
135 RED COACH DR  MISHAWAKA, IN 46545 US
Tel: 574-254-9200  Fax: 574-254-9202

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IN20040273A

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD000000221550IN01
200001180AIN05
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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