MEDICARE: MARIANELA TORRES

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
1	235Z00000X	Speech-Language Pathologist	16827	TX
2	235Z00000X	Speech-Language Pathologist	22005943A	IN

General Provider Information

NPI Number	:	1447384441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANELA TORRES

Provider Business Mailing Address
First Line	:	6631 AVILA WAY
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-4634
Country	:	US
Telephone Number	:	469-358-3697
Fax Number	:

Provider Business Practice Location Address
First Line	:	7424 SHADELAND STATION WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3925
Country	:	US
Telephone Number	:	317-288-7606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	09/25/2015

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Directions to “ MARIANELA TORRES ” Practice Location

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