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General NPI Number Information
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NPI Number | 1922391762
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH INSTITUTE FOR THE DEAF INDIANA SERVICE CORPORATION
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 9192 WALDEMAR RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1131
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Country | US
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Telephone | 317-471-8560
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 CLARKSON RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5065
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Country | US
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Telephone | 636-532-3211
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Fax | 636-532-4560
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DEBORAH WILSON
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Credential |
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Telephone | 636-532-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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