Healthcare Provider Details

I. General information

NPI: 1649036971
Provider Name (Legal Business Name): NATALIE PEARCE MHS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE GIRMAN

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 CAMPBELL ST
VALPARAISO IN
46385-2363
US

IV. Provider business mailing address

2155 SAINT JOSEPH LN
VALPARAISO IN
46385-5450
US

V. Phone/Fax

Practice location:
  • Phone: 219-462-1023
  • Fax:
Mailing address:
  • Phone: 219-921-3103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22007939A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: