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General NPI Number Information
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NPI Number | 1083124424
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Entity Type | Individual
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Provider Name | ANDREA J PURVIS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 2000 W UNIVERSITY AVE # HB419
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City | MUNCIE
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State | IN
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Zip | 47306-1157
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Country | US
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Telephone | 765-285-8166
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Fax |
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Provider Business Mailing Address
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Address Line | 6692 W DEER HILL DR
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City | MCCORDSVILLE
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State | IN
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Zip | 46055-4418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 46003239A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 14116340
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License Number State | IN
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