Healthcare Provider Details

I. General information

NPI: 1659207553
Provider Name (Legal Business Name): TERESA COCHRAN MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12188B N MERIDIAN ST STE 230
CARMEL IN
46032-4939
US

IV. Provider business mailing address

6204 BAYARD DR
NOBLESVILLE IN
46062-6488
US

V. Phone/Fax

Practice location:
  • Phone: 317-705-4640
  • Fax: 317-705-4649
Mailing address:
  • Phone: 317-508-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22004239A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: