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NPI Code Detail

MEDICARE: GRACE ELIZABETH RIVELLI CCC- SLP

MEDICARE: GRACE ELIZABETH RIVELLI CCC- SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist46003539AIN

General Provider Information

NPI Number : 1356993083
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE ELIZABETH RIVELLI CCC- SLP
Provider Business Mailing Address
First Line : 5724 SHARON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46228-1913
Country : US
Telephone Number : 812-240-3436
Fax Number :
Provider Business Practice Location Address
First Line : 7701 E 21ST ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-2406
Country : US
Telephone Number : 317-375-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2019
Last Update Date : 02/05/2026

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Directions to “ GRACE ELIZABETH RIVELLI CCC- SLP” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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