Provider Demographics
NPI:1629850417
Name:TOMLINSON, JANICE ELIZABETH
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ELIZABETH
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15911 RIBBON WALK LN APT 102
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-1629
Mailing Address - Country:US
Mailing Address - Phone:574-521-4417
Mailing Address - Fax:
Practice Address - Street 1:8333 NAAB RD STE 300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1983
Practice Address - Country:US
Practice Address - Phone:317-338-6499
Practice Address - Fax:317-338-9081
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009799A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical