Healthcare Provider Details

I. General information

NPI: 1225158454
Provider Name (Legal Business Name): JASON HANKEE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 KESSLER BOULEVARD EAST DR STE 235
INDIANAPOLIS IN
46220-2897
US

IV. Provider business mailing address

2620 KESSLER BOULEVARD EAST DRIVE SUITE 235
INDIANAPOLIS IN
46220
US

V. Phone/Fax

Practice location:
  • Phone: 317-762-8084
  • Fax: 317-353-3445
Mailing address:
  • Phone: 317-762-8084
  • Fax: 317-353-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number99023932A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: