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General NPI Number Information
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NPI Number | 1053846733
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Entity Type | Organization
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Legal Business Name | THE HOPE SOURCE
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 8350 CRAIG ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-3593
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Country | US
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Telephone | 317-578-0410
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Fax | 317-436-7409
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Provider Business Mailing Address
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Address Line | 8350 CRAIG ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-3593
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Country | US
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Telephone | 317-517-8817
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Fax | 317-436-7409
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Authorized Official
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Title or Position | EXECUTIVE CLINICAL DIRECTOR
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Name | DR. MOMI YAMANAKA
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Credential | PH.D. HSPP
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Telephone | 317-517-8817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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