Individual
MRS. TARA STARR PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP
Contact information
Practice address
3110 E COLISEUM BLVD, FORT WAYNE, IN 46805-1554
(260) 408-6732
(317) 449-5783
Mailing address
422 UNION STATION DR, FORT WAYNE, IN 46814-8965
(260) 450-7630
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004392A
IN
Other
Enumeration date
10/22/2012
Last updated
09/09/2022
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