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General NPI Number Information
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NPI Number | 1184874133
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Entity Type | Organization
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Legal Business Name | PEDIATRIC SPEECH AND LANGUAGE SOLUTIONS
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 11708 N COLLEGE AVE SUITE 150
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City | CARMEL
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State | IN
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Zip | 46032-5642
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Country | US
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Telephone | 317-569-0086
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Fax | 317-569-0344
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Provider Business Mailing Address
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Address Line | 11708 N COLLEGE AVE SUITE 1150
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City | CARMEL
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State | IN
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Zip | 46032-5642
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Country | US
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Telephone | 317-569-0086
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Fax | 317-569-0344
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JAIME L MILLER
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Credential | M.A., CCC-SLP
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Telephone | 317-569-0086
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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 | 22003620A
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License Number State | IN
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