Provider Demographics
NPI:1164212999
Name:NEAL, KATHLENE ELIZABETH RUTH
Entity type:Individual
Prefix:
First Name:KATHLENE
Middle Name:ELIZABETH RUTH
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 NORTHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-1618
Mailing Address - Country:US
Mailing Address - Phone:317-970-2141
Mailing Address - Fax:317-970-2141
Practice Address - Street 1:724 NORTHFIELD CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1618
Practice Address - Country:US
Practice Address - Phone:317-970-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst