Individual
STEPHANIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 703-1431
Mailing address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2959
(219) 703-1431
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006405A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039618
—
IN
Enumeration date
06/12/2020
Last updated
07/01/2020
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