NPI Registry.org

Bloomington Neurofeedback

NPI Registration Record

Provider / OrganizationNPIDate Certified
BLOOMINGTON NEUROFEEDBACK17105859972020-10-11
Entity TypeOrganization
Provider OrganizationBLOOMINGTON NEUROFEEDBACK
Practice Office Address1905 S LIBERTY DR
BLOOMINGTON, IN US
Practice Office Telephone8126686220
Practice Office Fax8126686225
Mailing Address1905 S LIBERTY DR
BLOOMINGTON, IN 474035146 US
Business Telephone8126886220
Business Fax8126686225
Authorized OfficialRHONDA SOUDER, OWNER
5022320405
HPT Codes
CodeLicense NoState
261QM0801X PRIMARY
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

© 2020 NPIRegistry.org | Contact | Privacy Policy
45 CFR Part 162