Individual
VALISA JEAN ROYSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1701 SENATE BLVD, SUITE AG045, INDIANAPOLIS, IN 46202-1239
(317) 962-4836
(317) 962-4812
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
23001175
IN
231H00000X
Audiologist
Primary
23001175A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001070985
ANTHEM PROVIDER NUMBER
IN
05
—
200544370
—
IN
05
—
300000626
—
IN
Enumeration date
08/01/2006
Last updated
12/10/2020
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