Provider Demographics
NPI:1285865378
Name:ANPS-IN LLC
Entity Type:Organization
Organization Name:ANPS-IN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:DEGRAZIA
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-650-0590
Mailing Address - Street 1:908 ROOSEVELT RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4375
Mailing Address - Country:US
Mailing Address - Phone:219-462-0246
Mailing Address - Fax:219-462-5032
Practice Address - Street 1:908 ROOSEVELT RD
Practice Address - Street 2:SUITE K
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4375
Practice Address - Country:US
Practice Address - Phone:219-462-0246
Practice Address - Fax:219-462-5032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042329A103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1245356112OtherPERSONAL NPI NUMBER