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General NPI Number Information
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NPI Number | 1487602660
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Entity Type | Organization
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Legal Business Name | SPEECH PATHOLOGY SERVICES, PC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1980 E 116TH ST SUITE 300
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City | CARMEL
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State | IN
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Zip | 46032-3599
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Country | US
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Telephone | 317-843-2801
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Fax |
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Provider Business Mailing Address
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Address Line | 1980 E 116TH ST SUITE 300
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City | CARMEL
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State | IN
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Zip | 46032-3599
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Country | US
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Telephone | 317-843-2801
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA A COBB
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Credential | M.A.-SLP
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Telephone | 317-843-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 22000370A
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License Number State | IN
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