Provider Demographics
NPI:1114276896
Name:SCHNELLENBERGER, MEGHAN MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MARIE
Last Name:SCHNELLENBERGER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MARIE
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:9002 N MERIDIAN STREET
Mailing Address - Street 2:SUITE 222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5350
Mailing Address - Country:US
Mailing Address - Phone:317-573-4370
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:9002 N MERIDIAN ST
Practice Address - Street 2:STE 222
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5350
Practice Address - Country:US
Practice Address - Phone:317-573-4370
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002518A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201117330Medicaid
IN267650001Medicare PIN