MEDICARE: MRS. APRIL DAWN CONDON CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	22002004A	IN

General Provider Information

NPI Number	:	1588697577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL DAWN CONDON CCC-SLP

Provider Business Mailing Address
First Line	:	4400 N 300 E
Second Line	:
City	:	ANDERSON
State	:	IN
Zip	:	46012-9520
Country	:	US
Telephone Number	:	765-378-3534
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 W RIVERSIDE AVE
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47306-9520
Country	:	US
Telephone Number	:	765-285-4422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	05/29/2024

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