Healthcare Provider Details

I. General information

NPI: 1366210585
Provider Name (Legal Business Name): TAMIKA C ZAPOLSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMIKA C BARKLEY

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 WISHARD BLVD STE 4110
INDIANAPOLIS IN
46202-4164
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-8162
  • Fax: 317-948-0609
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042801A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042801B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: