Healthcare Provider Details

I. General information

NPI: 1326085135
Provider Name (Legal Business Name): AMY BETH PIGOTT EGLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 EXECUTIVE PARK DR STE 3000E
GREENWOOD IN
46143-3204
US

IV. Provider business mailing address

720 EXECUTIVE PARK DR STE 3000E
GREENWOOD IN
46143-3204
US

V. Phone/Fax

Practice location:
  • Phone: 317-300-1414
  • Fax: 317-300-1414
Mailing address:
  • Phone: 317-300-1414
  • Fax: 317-300-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001485A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: