Individual
JANE BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
534 WALNUT LN, LOWELL, IN 46356-1665
(219) 696-6432
(219) 696-6432
Mailing address
534 WALNUT LN, LOWELL, IN 46356-1665
(219) 696-6432
(219) 696-6432
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003480A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200654350
—
IN
Enumeration date
04/18/2007
Last updated
09/24/2021
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