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NPI Code Detail

MEDICARE: DORIS ANN BRINEGAR M.A., CCC-SLP

MEDICARE: DORIS ANN BRINEGAR M.A., 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 Pathologist22005127AIN

General Provider Information

NPI Number : 1427367424
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIS ANN BRINEGAR M.A., CCC-SLP
Provider Business Mailing Address
First Line : 8641 FAWN LAKE CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-9776
Country : US
Telephone Number : 219-771-1466
Fax Number :
Provider Business Practice Location Address
First Line : 8641 FAWN LAKE CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-9776
Country : US
Telephone Number : 219-771-1466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2010
Last Update Date : 09/25/2010

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