Bracy, Odie L
Bracy, Odie L is an individual health care provider with primary practice located at 6555 Carrollton Ave , Indianapolis IN 46220-1664. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Bracy, Odie L can be contacted via phone (317) 257-9672.Contact Information
Primary practice address
6555 Carrollton Ave
Indianapolis IN 46220-1664
Phone: (317) 257-9672
Fax: (317) 257-9674
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 20010368A | Indiana |
Profile Details
NPI number | 1285639476 |
---|---|
LBN Legal business name | Bracy, Odie L |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 15th, 2005 |
Last updated | Dec 29th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1285639476 | NPPES |
Indiana | Other | 000000085922 | ANTHEM BC/BS |
Indiana | MEDICAID | 100073260 | ANTHEM BC/BS |
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