Individual
TISHANN STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7465 MADISON AVE, INDIANAPOLIS, IN 46227-6564
(317) 788-3000
(317) 788-3005
Mailing address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002334A
IN
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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