Provider Demographics
NPI:1407679137
Name:LICHLYTER, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:LICHLYTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 N GIRLS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3402
Mailing Address - Country:US
Mailing Address - Phone:317-988-6479
Mailing Address - Fax:
Practice Address - Street 1:1129 N GIRLS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3402
Practice Address - Country:US
Practice Address - Phone:317-988-6479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool