Individual
MARY IPPOLITI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC/SLP
Contact information
Practice address
2300 PARKVIEW LN, ELWOOD, IN 46036-1378
(765) 552-9884
Mailing address
4511 COLUMBUS AVE APT H-55, ANDERSON, IN 46013-5113
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22005956A
ST LICENSE
IN
Enumeration date
12/03/2014
Last updated
12/03/2014
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