Individual
AMANDA BROOKE MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005977A
IN
235Z00000X
Speech-Language Pathologist
Primary
46002363A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46002363A
INDIANA SLP LICENSE
IN
Enumeration date
08/20/2012
Last updated
02/06/2026
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