Doctor Name: | JAMES M BOVAN |
NPI Number: | 1063571727 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D |
License Number: | 20042139A |
Business Practice Address: | 8400 Louisiana St Merrillville, IN - 464106385 |
Business Phone Number: | 2197571924 |
Business Fax Number: | 2197571950 |
Mailing Address: | 1348 S Lake Park Ave, HOBART |
State: | IN |
Postal Code: | 463425964 |
Phone Number: | 2199424040 |
Fax Number: | 2197369131 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 20042139A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |