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NPI Code Detail

MEDICARE: MRS. AMY RENE BRANT MSE, LSC, LMFTA

MEDICARE: MRS. AMY RENE BRANT MSE, LSC, LMFTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist85000196AIN

General Provider Information

NPI Number : 1083019954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY RENE BRANT MSE, LSC, LMFTA
Provider Business Mailing Address
First Line : 9953 CROSSPOINT BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3391
Country : US
Telephone Number : 317-414-0190
Fax Number :
Provider Business Practice Location Address
First Line : 9953 CROSSPOINT BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3391
Country : US
Telephone Number : 317-414-0190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2014
Last Update Date : 06/03/2026

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