Provider Demographics
NPI:1073532537
Name:LICHTENBERG, EMILY C (MS)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:C
Last Name:LICHTENBERG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 HARCOURT RD STE 324
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2052
Mailing Address - Country:US
Mailing Address - Phone:317-338-7475
Mailing Address - Fax:317-583-2436
Practice Address - Street 1:8402 HARCOURT RD STE 324
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2052
Practice Address - Country:US
Practice Address - Phone:317-338-7475
Practice Address - Fax:317-583-2436
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS