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General NPI Number Information
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NPI Number | 1366405961
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 PLAZA EAST BLVD SUITE 119
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City | EVANSVILLE
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State | IN
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Zip | 47715-2870
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Country | US
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Telephone | 812-421-7273
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Fax | 812-421-7281
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Provider Business Mailing Address
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Address Line | 101 PLAZA EAST BLVD SUITE 119
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City | EVANSVILLE
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State | IN
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Zip | 47715-2870
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Country | US
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Telephone | 812-421-7273
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Fax | 812-421-7281
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BARBARA A BARLOW
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Credential | MA ED CRC
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Telephone | 812-421-7273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20090095A
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License Number State | IN
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