Individual
MADISON N HAGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
705 RILEY HOSPITAL DR STE 2210, INDIANAPOLIS, IN 46202-5109
(317) 944-8868
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007427A
IN
235Z00000X
Speech-Language Pathologist
46004388A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103779393
ANTHEM PTAN
IN
Enumeration date
10/06/2023
Last updated
09/26/2024
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