| Doctor Name: | GREGORY CORRELL |
| NPI Number: | 1326045063 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 20040294A |
| Business Practice Address: | 9904 Ridgeway Ct Mc Cordsville, IN - 460559790 |
| Business Phone Number: | 3173353871 |
| Business Fax Number: | |
| Mailing Address: | 17330 W Center Rd, Suite 110-282 OMAHA |
| State: | NE |
| Postal Code: | 681302392 |
| Phone Number: | 3174469288 |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 09/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 20040294A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |