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NPI Code Detail

MEDICARE: DANA STEWART MA, CCC-SLP

MEDICARE:   DANA  STEWART  MA, 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 Pathologist22003946AIN

General Provider Information

NPI Number : 1558520072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA STEWART MA, CCC-SLP
Provider Business Mailing Address
First Line : 1707 W 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1707 W 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2002
Country : US
Telephone Number : 317-415-5505
Fax Number : 317-415-5635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2008
Last Update Date : 06/09/2008

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Directions to “ DANA STEWART MA, CCC-SLP” Practice Location

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