Doctor Name: | DR. SHANA MARKLE |
NPI Number: | 1013375823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 20042432A |
Business Practice Address: | 800 Fulton St Logansport, IN - 469471577 |
Business Phone Number: | 5747225151 |
Business Fax Number: | 5747221791 |
Mailing Address: | 800 Fulton St, LOGANSPORT |
State: | IN |
Postal Code: | 469471577 |
Phone Number: | 5747225151 |
Fax Number: | 5747221791 |
NPI Enumeration Date: | 02/08/2016 |
NPI Last Update Date: | 02/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 20042432A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |