MEDICARE: AEGEAN PERFORMANCE CONSULTING

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1235792698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEGEAN PERFORMANCE CONSULTING

Provider Business Mailing Address
First Line	:	1112 INDIANAPOLIS BLVD
Second Line	:
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-1361
Country	:	US
Telephone Number	:	219-810-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 INDIANAPOLIS BLVD STE 107
Second Line	:
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-1361
Country	:	US
Telephone Number	:	219-810-2424
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZUBEYDE SEDA GULVAS
Credential	:	PHD
Telephone Number	:	219-810-2424

Provider Enumeration Date	:	04/20/2019
Last Update Date	:	06/06/2019

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Directions to “AEGEAN PERFORMANCE CONSULTING ” Practice Location

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