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Lise D Delong, PHDCPCRT
Developmental Disabilities Clinic/Center in Greenwood, Indiana
NPI 1295030666

Lise D Delong is a Developmental Disabilities Clinic/Center based in Greenwood, IN and is specialized in Developmental Disabilities. Lise D Delong practices in Greenwood, IN and has the professional credentials of PHDCPCRT. The NPI Number for Lise D Delong is 1295030666 and holds a License No. (Indiana).

The current practice location address for Lise D Delong is 1678 Fry Rd Ste C, Greenwood, IN and can be reached out via phone at 317-888-7420.

Location: 1678 Fry Rd Ste C, Greenwood, IN, 46142-1176
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295030666
Provider Name
Lise D Delong
Credential
PHDCPCRT
Provider Entity Type
Individual
Gender
Female
Address
1678 Fry Rd Ste C, Greenwood, IN, 46142-1176
Phone Number
317-888-7420
Fax Number
Provider Enumeration Date
01/17/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1678 Fry Rd Ste C
City
Greenwood
State
Indiana
Zip
46142-1176
Phone Number
317-888-7420
Fax Number
person
Provider Business Mailing Address Details
Address
1678 Fry Rd Ste C
City
Greenwood
State
Indiana
Zip
46142-1176
Phone Number
317-888-7420
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
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Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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