Provider Demographics
NPI:1154512101
Name:MISETIC, CARA AILEEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:AILEEN
Last Name:MISETIC
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 S EMERSON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1912
Mailing Address - Country:US
Mailing Address - Phone:317-889-3901
Mailing Address - Fax:317-889-3902
Practice Address - Street 1:494 S EMERSON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1912
Practice Address - Country:US
Practice Address - Phone:317-889-3901
Practice Address - Fax:317-889-3902
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042131A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical