Provider Demographics
NPI:1013370303
Name:TOBENAS, MARTA MARIA (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:MARIA
Last Name:TOBENAS
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 LAKETON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4190
Mailing Address - Country:US
Mailing Address - Phone:317-923-2333
Mailing Address - Fax:317-923-2367
Practice Address - Street 1:4401 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1822
Practice Address - Country:US
Practice Address - Phone:317-923-2333
Practice Address - Fax:317-923-2367
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103K00000X
IN20043477A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst