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General NPI Number Information
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NPI Number | 1811389182
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Entity Type | Individual
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Provider Name | ANNA EDENS-SZESZYCKI
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Gender | Female
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 2105 N MERIDIAN ST SUITE 102
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1491
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Country | US
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Telephone | 317-926-5463
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Fax | 317-956-5498
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Provider Business Mailing Address
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Address Line | 2105 N MERIDIAN ST SUITE 102
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1491
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Country | US
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Telephone | 317-926-5463
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Fax | 317-926-5498
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 1681-0-ASO
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License Number State | IN
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