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General NPI Number Information
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NPI Number | 1144343963
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Entity Type | Individual
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Provider Name | ALICIA MARIE DILLINGHAM M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2007
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 1456 STONEMILL CIR S
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City | CARMEL
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State | IN
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Zip | 46032-8297
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Country | US
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Telephone | 317-406-9846
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Fax |
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Provider Business Mailing Address
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Address Line | 1456 STONEMILL CIR S
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City | CARMEL
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State | IN
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Zip | 46032-8297
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Country | US
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Telephone | 317-331-9846
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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 | 22004363A
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License Number State | IN
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