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General NPI Number Information
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NPI Number | 1508803164
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Entity Type | Individual
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Provider Name | DANIEL F REXROTH PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 355 W 16TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2207
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Country | US
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Telephone | 317-963-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone | 317-962-3834
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20041914A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 20041914
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 20041914A
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License Number State | IN
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