Provider Demographics
NPI:1639200785
Name:PADILLA, TRINIDAD CLAUDIA (MS , SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:TRINIDAD
Middle Name:CLAUDIA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MS , SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 43RD ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3035
Mailing Address - Country:US
Mailing Address - Phone:219-306-1748
Mailing Address - Fax:
Practice Address - Street 1:3647 43RD ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3035
Practice Address - Country:US
Practice Address - Phone:219-306-1748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist