Provider Demographics
NPI:1528225620
Name:WALKER, ROANNA TRUVINE (MED/CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ROANNA
Middle Name:TRUVINE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6249 S. EAST ST. SUITE E
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227
Mailing Address - Country:US
Mailing Address - Phone:630-234-8969
Mailing Address - Fax:
Practice Address - Street 1:6249 S EAST ST STE E
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2089
Practice Address - Country:US
Practice Address - Phone:630-234-8969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004325235Z00000X
NC7241235Z00000X
GASLP006672235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist