Individual
LISA THANH XUAN LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA; CCC-SLP
Contact information
Practice address
6925 PARKDALE PL, INDIANAPOLIS, IN 46254-4673
(855) 324-0885
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007569A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22007569A
SLP LICENSE
IN
Enumeration date
08/19/2020
Last updated
08/19/2020
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