Provider Demographics
NPI:1346453941
Name:COFRESI, ANA VELIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:VELIA
Last Name:COFRESI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10585 NORTH MERIDIAN STREET
Mailing Address - Street 2:SUITE 340
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1129
Mailing Address - Country:US
Mailing Address - Phone:317-580-4012
Mailing Address - Fax:317-580-4010
Practice Address - Street 1:10585 N MERIDIAN ST
Practice Address - Street 2:SUITE 340
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1069
Practice Address - Country:US
Practice Address - Phone:317-580-4012
Practice Address - Fax:317-580-4010
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040960A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical