Vajra Psychological Services, LLC
Organization Active NPI Psychologist · North Vernon, IN
NPI 1740528702 · NPPES record last updated Feb 8, 2013
Key facts
- NPI
- 1740528702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- 20042015A (IN)
- Legal business name
- VAJRA PSYCHOLOGICAL SERVICES, LLC
- Practice address
- 753 N State St
Suite J
North Vernon, IN 47265-1044 - Phone
- (812) 346-7744
- Fax
- (812) 346-3815
- NPI assigned
- Jan 26, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason Holland, PHD
- Title
- Owner
- Phone
- (812) 498-3470
National Provider Directory
Locations
753 N State St
Ste J
North Vernon, IN 47265
Phone (812) 346-7744
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 20042015A | IN | Yes |
Addresses
Primary practice location
753 N State St
Suite J
North Vernon, IN 47265-1044
Mailing address
753 N State St
Suite J
North Vernon, IN 47265-1044
Phone (812) 346-7744
Other providers in North Vernon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.