Healthcare Provider Details

I. General information

NPI: 1124227830
Provider Name (Legal Business Name): ALICE NJUNGE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 HANNAH PL
FRANKLIN IN
46131-7493
US

IV. Provider business mailing address

3511 E 46TH ST STE K-2
INDIANAPOLIS IN
46205
US

V. Phone/Fax

Practice location:
  • Phone: 317-738-0545
  • Fax: 317-738-0545
Mailing address:
  • Phone: 317-273-8897
  • Fax: 317-273-8862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: