Provider Demographics
NPI:1245191196
Name:PIERRE PAUL, ELOURDES
Entity type:Individual
Prefix:
First Name:ELOURDES
Middle Name:
Last Name:PIERRE PAUL
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 1:2628 FOX HARBOUR LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-3823
Mailing Address - Country:US
Mailing Address - Phone:754-779-2810
Mailing Address - Fax:
Practice Address - Street 1:2628 FOX HARBOUR LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-3823
Practice Address - Country:US
Practice Address - Phone:754-779-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3747PI801X103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty