Provider Demographics
NPI:1053483628
Name:DOBBS, JAMES MARK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARK
Last Name:DOBBS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6337 HOLLISTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-4725
Mailing Address - Country:US
Mailing Address - Phone:317-291-9007
Mailing Address - Fax:317-291-9061
Practice Address - Street 1:6337 HOLLISTER DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-4725
Practice Address - Country:US
Practice Address - Phone:317-291-9007
Practice Address - Fax:317-291-9061
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040971A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical