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NPI 1700165032

NPI 1700165032 : TIM HORSMAN : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1700165032
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    Entity Type          |    Individual 
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    Provider Name        |    TIM HORSMAN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/04/2011
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    Last Update Date     |    08/04/2011
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Provider Practice Location Address
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    Address Line         |    1500 NORTH RITTER AVENUE 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46219-3027
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    Country              |    US
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    Telephone            |    317-355-2560
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    Fax                  |    317-355-2418
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Provider Business Mailing Address
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    Address Line         |    8180 CLEARVISTA PARKWAY SUITE 230
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46256-4649
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    Country              |    US
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    Telephone            |    
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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        |    101YS0200X
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    Taxonomy Name        |    School Counselor
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    License Number       |    
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    License Number State |    IN
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