Individual
JEAN THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLT-A
Contact information
Practice address
3948 NEW VISION DR STE D, FORT WAYNE, IN 46845-1721
(260) 245-1455
(317) 815-3861
Mailing address
6060 N COLLEGE AVE, INDIANAPOLIS, IN 46220-1907
(260) 245-1455
(317) 815-3861
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
29001691A
IN
Other
Enumeration date
12/13/2017
Last updated
03/17/2018
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