Provider Demographics
NPI:1144422734
Name:SHAH, SNEHA D (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7440 N SHADELAND AVE STE 150
Mailing Address - Street 2:STE 150
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2095
Mailing Address - Country:US
Mailing Address - Phone:317-842-4901
Mailing Address - Fax:317-842-4393
Practice Address - Street 1:7440 N SHADELAND AVE STE 150
Practice Address - Street 2:STE 150
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2095
Practice Address - Country:US
Practice Address - Phone:317-842-4901
Practice Address - Fax:317-842-4393
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002269A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist