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Individual

MRS. RACHELLE LYN FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
8616 W 10TH ST, INDIANAPOLIS, IN 46234-2167
(317) 209-2332
Mailing address
8607 ROBIN RUN WAY, AVON, IN 46123-1218
(317) 203-6278

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46001588A
IN

Other

Enumeration date
05/17/2007
Last updated
07/08/2007
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