Jill C. Fodstad PHD, HSPP
Psychologist in Indianapolis, IN(View on Map)
Full Name
Jill Cherie Fodstad PHD, HSPP
NPI Number
1710237458
NPI Type
Individual Provider
Gender
Female
Enumeration Date
09/10/2012
Specialties
(Taxonomies)Licenses
State
Indiana
Maryland
License Number
20042696A
05202
Contact
Information
Purpose
Mailing
Location
Address
250 N SHADELAND AVE
705 RILEY HOSPITAL DR
City
Indianapolis
Indianapolis
State
IN
IN
Postal Code
46219-4959
46202-5109
Country
US
US
Telephone Number
N/A
(317) 944-2066
Identifiers
Identifier
201183590
Identifier State
IN
Identifier Issuer
Unknown
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
jfodstad@direct.iuhealth.org
Endpoint Description
Unknown
Use
Unknown
Content Type
Unknown
Affiliation
N
Endpoint Location
705 Riley Hospital DrIndianapolis, IN462025109US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/21/2021
Provider Address
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