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General NPI Number Information
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NPI Number | 1578835013
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Entity Type | Organization
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Legal Business Name | CARMEL NEUROPSYCHOLOGY SERVICES, P.C.
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 755 W CARMEL DR SUITE 205
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City | CARMEL
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State | IN
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Zip | 46032-5877
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Country | US
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Telephone | 317-775-8966
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Fax |
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Provider Business Mailing Address
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Address Line | 755 W CARMEL DR SUITE 205
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City | CARMEL
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State | IN
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Zip | 46032-5877
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Country | US
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Telephone | 317-775-8966
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Fax |
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. JAVAN LEE HORWITZ
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Credential | PSY.D.
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Telephone | 317-775-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 20042257A
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License Number State | IN
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