Enneking, Brett Alicia
Enneking, Brett Alicia is an individual health care provider with primary practice located at 705 Riley Hospital Dr , Indianapolis IN 46202-5109. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Enneking, Brett Alicia can be contacted via phone (317) 944-8167.Contact Information
Primary practice address
705 Riley Hospital Dr
Indianapolis IN 46202-5109
Phone: (317) 944-8167
Fax: (317) 944-9760
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 20043128A | Indiana |
Profile Details
| NPI number | 1538654371 |
|---|---|
| LBN Legal business name | Enneking, Brett Alicia |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2018 |
| Last updated | Jan 26th, 2021 - about 4 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 | 1538654371 | NPPES |
| Indiana | Other | 300015970 | MEDICAID |
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