Individual
LYDIA SUSAN COALBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 N COURTLAND AVE, KOKOMO, IN 46901-2755
(765) 461-3760
Mailing address
1820 S 750 W, RUSSIAVILLE, IN 46979-9736
(765) 461-3760
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
29001974A
IN
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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