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General NPI Number Information
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NPI Number | 1467272997
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Entity Type | Individual
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Provider Name | GRACE HAIGH BURRIS EDS
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Gender | Female
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 3025 WESTFIELD RD
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City | NOBLESVILLE
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State | IN
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Zip | 46062-8905
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Country | US
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Telephone | 317-773-2915
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Fax |
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Provider Business Mailing Address
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Address Line | 3737 SHAFER CIR
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City | CARMEL
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State | IN
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Zip | 46033-4728
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Country | US
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Telephone | 317-796-7540
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10319719
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License Number State | IN
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