Healthcare Provider Details

I. General information

NPI: 1265547228
Provider Name (Legal Business Name): SUZANNE M FOLEY M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 N SHADELAND AVE STE 115
INDIANAPOLIS IN
46250-2985
US

IV. Provider business mailing address

7440 N SHADELAND AVE STE 115
INDIANAPOLIS IN
46250-2985
US

V. Phone/Fax

Practice location:
  • Phone: 317-573-4445
  • Fax: 317-577-7330
Mailing address:
  • Phone: 317-573-4445
  • Fax: 317-577-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002045A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number23002045A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23002045A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: