Healthcare Provider Details

I. General information

NPI: 1215427067
Provider Name (Legal Business Name): ASSOCIATES IN BEHAVIORAL HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W WHITE RIVER BLVD
MUNCIE IN
47303-3866
US

IV. Provider business mailing address

708 W WHITE RIVER BLVD
MUNCIE IN
47303-3866
US

V. Phone/Fax

Practice location:
  • Phone: 765-748-8112
  • Fax:
Mailing address:
  • Phone: 765-748-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20041822A
License Number StateIN

VIII. Authorized Official

Name: ROBYN NICOLE EUBANK
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 765-748-8112