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General NPI Number Information
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NPI Number | 1346122777
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Entity Type | Individual
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Provider Name | MAHBOOBEH AYATOLLAHZADEH PHD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 120 E WALNUT ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-1312
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Country | US
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Telephone | 317-226-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 14025 SETTLERS RIDGE TRL
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City | CARMEL
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State | IN
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Zip | 46033-8295
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Country | US
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Telephone | 650-868-5621
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Fax | 650-868-5621
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1401878
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License Number State | IN
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