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NPI Code Detail

MEDICARE: ERIN MARIE RUNDLE SLP

MEDICARE: ERIN MARIE RUNDLE 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 Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122006895AOTHERINBOARD OF SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY

General Provider Information

NPI Number : 1801419643
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN MARIE RUNDLE SLP
Provider Business Mailing Address
First Line : 3374 PAISLEY POINTE
Second Line :
City : WHITESTOWN
State : IN
Zip : 46075-9781
Country : US
Telephone Number : 574-276-0331
Fax Number :
Provider Business Practice Location Address
First Line : 3895 S KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-3540
Country : US
Telephone Number : 574-276-0331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2020
Last Update Date : 05/28/2020

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Directions to “ ERIN MARIE RUNDLE SLP” Practice Location

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