Individual
LYDIA R KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2320 CONCORD RD STE A, LAFAYETTE, IN 47909-2710
(765) 477-7436
(765) 477-1245
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005444A
IN
Other
Enumeration date
07/22/2020
Last updated
01/31/2025
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