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Individual

MISS NICOLE S SHOOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
4470 N COLLEGE AVE, INDIANAPOLIS, IN 46205-1980
(317) 331-1898
Mailing address
4470 N COLLEGE AVE, INDIANAPOLIS, IN 46205-1980
(317) 331-1898

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004116A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200679640
IN
Enumeration date
02/22/2007
Last updated
09/16/2008
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