Individual
MRS. TISHA NICOLE VANCUREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1060 E 86TH ST, SUITE 65C, INDIANAPOLIS, IN 46240-1863
(317) 696-4551
Mailing address
10452 DARK STAR DR, INDIANAPOLIS, IN 46234-9853
(317) 696-4874
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004613A
IN
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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