Doctor Name: | REGAN MOSHER-RUDOLF |
NPI Number: | 1104257930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 39002160A |
Business Practice Address: | 766 Heartland Ln Brownsburg, IN - 461127671 |
Business Phone Number: | 3176700311 |
Business Fax Number: | |
Mailing Address: | 766 Heartland Ln, BROWNSBURG |
State: | IN |
Postal Code: | 461127671 |
Phone Number: | 3176700311 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2013 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39002160A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |