Individual
MRS. JENISE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
3640 CENTRAL AVE, INDIANAPOLIS, IN 46205-3569
(317) 920-7888
Mailing address
3640 CENTRAL AVE, INDIANAPOLIS, IN 46205-3569
(317) 920-7888
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006171A
IN
235Z00000X
Speech-Language Pathologist
46002624A
IN
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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