Individual
MRS. JENICA L TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
1111 RONALD REAGAN PKWY, AVON, IN 46123-7085
(317) 217-3079
(317) 217-3073
Mailing address
8440 WANDA LAKE DR, CAMBY, IN 46113-8718
(317) 626-4923
(317) 217-3073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004455A
IN
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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