Provider Demographics
NPI:1467478487
Name:VONBLON, KIRA SUZANNE (MA)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:SUZANNE
Last Name:VONBLON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12065 OLD MERIDIAN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-705-2700
Mailing Address - Fax:317-575-3797
Practice Address - Street 1:12065 OLD MERIDIAN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-705-2700
Practice Address - Fax:317-575-3797
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002232A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist