Individual
MRS. ALICIA ILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7209 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2021
(317) 288-7606
Mailing address
1514 CLIFTON AVE, LOGANSPORT, IN 46947-1420
(765) 714-5677
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
2355S0801X
Speech-Language Assistant
29001657A
IN
Other
Enumeration date
02/08/2019
Last updated
09/13/2023
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