Individual
MRS. KORTNI REANN MARTINDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
368 W INDIANA AVE, SULLIVAN, IN 47882-1117
(812) 564-1229
(812) 268-3947
Mailing address
368 W INDIANA AVE, SULLIVAN, IN 47882-1117
(812) 564-1229
(812) 268-3947
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004417A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200866400 A
LEGACY PROVIDER IDENTIFIER
IN
Enumeration date
04/21/2008
Last updated
04/21/2008
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