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Individual

ELIZABETH J PROVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
9031 CRYSTAL LAKE DR, INDIANAPOLIS, IN 46240-6414
(574) 265-9338
(574) 587-9605
Mailing address
9031 CRYSTAL LAKE DR, INDIANAPOLIS, IN 46240-6414
(574) 265-9338
(574) 265-9338

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.011786
IL
235Z00000X
Speech-Language Pathologist
Primary
22004884A
IN
235Z00000X
Speech-Language Pathologist
242000963
IL

Other

Enumeration date
08/18/2008
Last updated
03/27/2019
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