MEDICARE: KATHY DRIGGERS MA

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1235647223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY DRIGGERS MA

Provider Business Mailing Address
First Line	:	4735 CHARRINGTON CIR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-9671
Country	:	US
Telephone Number	:	317-500-2201
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 SUNNYFIELD CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46228-3100
Country	:	US
Telephone Number	:	317-500-2201
Fax Number	:	317-500-2201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2018
Last Update Date	:	01/12/2018

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