Individual
MARIA LYNN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
355 W 16TH ST STE 3000, INDIANAPOLIS, IN 46202-2207
(317) 963-7089
(317) 963-7085
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002762A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063220080
MEDICARE
IN
05
—
300059742
—
IN
Enumeration date
11/03/2021
Last updated
05/10/2022
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