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General NPI Number Information
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NPI Number | 1538920236
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Entity Type | Organization
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Legal Business Name | DR. ADAM DELL, LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 210 S RACE ST
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City | MISHAWAKA
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State | IN
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Zip | 46544-2032
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Country | US
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Telephone | 574-527-6298
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Fax |
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Provider Business Mailing Address
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Address Line | 59280 BLACKBIRD CT
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City | GOSHEN
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State | IN
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Zip | 46528-8341
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Country | US
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Telephone | 574-527-6298
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | ADAM DAVID DELL
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Credential | PSYD
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Telephone | 574-527-6298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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