MEDICARE: MRS. TARA LYNN HOPF 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
1	235Z00000X	Speech-Language Pathologist	22004125A	IN

General Provider Information

NPI Number	:	1598965592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA LYNN HOPF M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2414 SOUTH SAINT ANTHONY ROAD NORTH
Second Line	:
City	:	SAINT ANTHONY
State	:	IN
Zip	:	47575-9747
Country	:	US
Telephone Number	:	812-639-0027
Fax Number	:	812-326-2409

Provider Business Practice Location Address
First Line	:	2414 SOUTH SAINT ANTHONY ROAD NORTH
Second Line	:
City	:	SAINT ANTHONY
State	:	IN
Zip	:	47575-9747
Country	:	US
Telephone Number	:	812-639-0027
Fax Number	:	812-326-2409

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	07/19/2007

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Directions to “ MRS. TARA LYNN HOPF M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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