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General NPI Number Information
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NPI Number | 1366326811
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Entity Type | Individual
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Provider Name | REBECCA KOMINSKY PHD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 10293 N MERIDIAN ST STE 210
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City | CARMEL
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State | IN
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Zip | 46290-1079
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Country | US
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Telephone | 317-806-0209
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Fax | 317-960-3739
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Provider Business Mailing Address
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Address Line | 1115 W 72ND ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-4038
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Country | US
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Telephone | 410-818-9932
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 20043815A
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License Number State | IN
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