Healthcare Provider Details

I. General information

NPI: 1326785502
Provider Name (Legal Business Name): ALISSA HUGHES SLP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 SOUTHEASTERN AVE
INDIANAPOLIS IN
46202-3948
US

IV. Provider business mailing address

14257 AUTUMN WOODS DRIVE
CARMEL IN
46074
US

V. Phone/Fax

Practice location:
  • Phone: 317-660-1224
  • Fax: 855-595-2585
Mailing address:
  • Phone: 317-345-1324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISSA HUGHES
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: SLP
Phone: 317-345-1324