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General NPI Number Information
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NPI Number | 1376833715
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Entity Type | Organization
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Legal Business Name | EMPOWERED LIVING INC.
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Dates
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Enumeration Date | 04/18/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 6214 MORENCI TRL SUITE 220
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-4871
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Country | US
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Telephone | 317-683-6533
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Fax |
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Provider Business Mailing Address
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Address Line | 6214 MORENCI TRL SUITE 220
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-4871
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Country | US
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Telephone | 317-683-6533
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MR. HAROLD MOE
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Credential | LMFT
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Telephone | 317-683-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 350000528
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License Number State | IN
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