Individual
MS. DAWN ELIZABETH WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT CCC
Contact information
Practice address
500 OVAL DRIVE, HEAVILON HALL G34D, WEST LAFAYETTE, IN 47907-2038
(765) 494-3816
(765) 494-0771
Mailing address
601 STADIUM MALL DRIVE, WEST LAFAYETTE, IN 47907-2052
(765) 496-1927
(765) 496-1227
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22001747
IN
235Z00000X
Speech-Language Pathologist
Primary
22001747A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000553114
ANTHEM
IN
05
—
200891420
—
IN
Enumeration date
11/09/2007
Last updated
11/17/2009
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