Individual
MARY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
7701 E 21ST ST, INDIANAPOLIS, IN 46219-2406
(317) 329-1000
Mailing address
31 E 45TH ST, INDIANAPOLIS, IN 46205-1709
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007203A
IN
235Z00000X
Speech-Language Pathologist
LL60886804
WA
Other
Enumeration date
10/04/2018
Last updated
08/18/2023
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