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Individual

SUSAN DENISE TOLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2233
(317) 988-0018
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2233
(317) 988-0018

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001629A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22001629A
SPEECH STATE LICENSE
IN
Enumeration date
08/15/2006
Last updated
07/08/2007
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