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General NPI Number Information
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NPI Number | 1093378085
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Entity Type | Individual
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Provider Name | PAYAL J PATEL PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 2230 INDIANAPOLIS BLVD
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City | WHITING
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State | IN
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Zip | 46394-1956
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Country | US
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Telephone | 219-659-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 2230 INDIANAPOLIS BLVD
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City | WHITING
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State | IN
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Zip | 46394-1956
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Country | US
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Telephone | 847-454-5179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043227A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071010004
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License Number State | IL
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