Healthcare Provider Details
I. General information
NPI: 1063608438
Provider Name (Legal Business Name): ALLISON MCGINLEY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/19/2007
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9240 N MERIDIAN ST SUITE 320
INDIANAPOLIS IN
46260-1880
US
IV. Provider business mailing address
9240 N MERIDIAN ST SUITE 320
INDIANAPOLIS IN
46260-1880
US
V. Phone/Fax
- Phone: 317-844-7489
- Fax:
- Phone: 317-844-7489
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 20042169A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 20042169 |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: