Individual
MRS. ANDRIA GRACE WORKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
3771 LARAMIE DR, LAFAYETTE, IN 47905-4022
(765) 426-9306
Mailing address
3771 LARAMIE DR, LAFAYETTE, IN 47905-4022
(765) 426-9306
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004729A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12089398
AMERICAN SPEECH AND HEARING ASSOCIATION
—
01
—
22004729A
INDIANA PROFESSIONAL LICENSING AGENCY-SPEECH-LANGUAGE PATHOLOGY
IN
Enumeration date
08/13/2020
Last updated
08/13/2020
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