| Doctor Name: | DR. AIMEE DERSHOWITZ |
| NPI Number: | 1154762664 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 20042722A |
| Business Practice Address: | 1000 N Broadway Ste A Peru, IN - 469701070 |
| Business Phone Number: | 7654721931 |
| Business Fax Number: | 7654721945 |
| Mailing Address: | 1000 N Broadway Ste A, PERU |
| State: | IN |
| Postal Code: | 469701070 |
| Phone Number: | 7654721931 |
| Fax Number: | 7654721945 |
| NPI Enumeration Date: | 07/12/2013 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 20042722A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |