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General NPI Number Information
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NPI Number | 1700604139
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Entity Type | Individual
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Provider Name | KIM MARIE MANOIL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 5740 MCFARLAND RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-8719
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Country | US
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Telephone | 317-789-4427
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Fax |
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Provider Business Mailing Address
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Address Line | 5740 MCFARLAND RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-8719
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1551673
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License Number State | IN
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