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General NPI Number Information
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NPI Number | 1750531950
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Entity Type | Individual
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Provider Name | LAURA LEA FRAGOMENI AU.D.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 8202 CLEARVISTA PKWY STE 8B
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1456
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Country | US
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Telephone | 317-436-8306
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Fax | 317-436-8462
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Provider Business Mailing Address
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Address Line | 8202 CLEARVISTA PKWY STE 8B
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1456
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Country | US
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Telephone | 173-436-8306
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Fax | 317-436-8462
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002438A
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License Number State | IN
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