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Organization
INDIANA UNIVERSITY
Active
Organization
INDIANA UNIVERSITY
Active
Other names
IU Speech and Hearing Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA A HUMPHRESS (FISCAL OFFICER)
(812) 855-4156
Entity
Organization
Contact information
Practice address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 855-4156
(812) 855-5531
Mailing address
2631 EAST DISCOVERY PARKWAY, HEALTH SCIENCES BUILDING, BLOOMINGTON, IN 47408-9059
(812) 855-4156
(812) 855-5531
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
IN
235Z00000X
Speech-Language Pathologist
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100276980A
—
IN
Enumeration date
10/14/2005
Last updated
02/01/2021
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