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General NPI Number Information
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NPI Number | 1992360416
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Entity Type | Individual
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Provider Name | SYDNEY BETH ISLEY
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Gender | Female
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 12770 W NEW MARKET ST STE 206
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City | CARMEL
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State | IN
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Zip | 46032-7443
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Country | US
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Telephone | 909-907-4236
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Fax |
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Provider Business Mailing Address
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Address Line | 12770 W NEW MARKET ST STE 206
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City | CARMEL
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State | IN
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Zip | 46032-7453
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Country | US
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Telephone | 317-660-5532
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 35002254A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 88861
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License Number State | CA
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