| Doctor Name: | DR. MICHAEL A DRAKE |
| NPI Number: | 1023095338 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY D HSPP |
| License Number: | 20040859A |
| Business Practice Address: | 515 Bayou St Vincennes, IN - 475911034 |
| Business Phone Number: | 8128866800 |
| Business Fax Number: | 8128866809 |
| Mailing Address: | 515 Bayou St, VINCENNES |
| State: | IN |
| Postal Code: | 475911034 |
| Phone Number: | 8128866800 |
| Fax Number: | 8128866809 |
| NPI Enumeration Date: | 12/28/2005 |
| NPI Last Update Date: | 10/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 20040859A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |