Provider Demographics
NPI:1619153616
Name:CSIKOS, AUDREY L (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:L
Last Name:CSIKOS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 CENTURION PKWY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2503
Mailing Address - Country:US
Mailing Address - Phone:317-518-6216
Mailing Address - Fax:
Practice Address - Street 1:1885 CENTURION PKWY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2503
Practice Address - Country:US
Practice Address - Phone:317-518-6216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004513A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist