Provider Demographics
NPI:1881450492
Name:LAPSLEY, DETRICH
Entity type:Individual
Prefix:
First Name:DETRICH
Middle Name:
Last Name:LAPSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 LATITUDES PL APT 319
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8384
Mailing Address - Country:US
Mailing Address - Phone:317-590-6328
Mailing Address - Fax:
Practice Address - Street 1:6630 LATITUDES PL APT 319
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8384
Practice Address - Country:US
Practice Address - Phone:317-590-6328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty