Provider Demographics
NPI:1710598594
Name:WORKMAN, ANDRIA GRACE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANDRIA
Middle Name:GRACE
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MS
Other - First Name:ANDRIA
Other - Middle Name:GRACE
Other - Last Name:BATTAGLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:3771 LARAMIE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4022
Mailing Address - Country:US
Mailing Address - Phone:765-426-9306
Mailing Address - Fax:
Practice Address - Street 1:3771 LARAMIE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4022
Practice Address - Country:US
Practice Address - Phone:765-426-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004729A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN22004729AOtherINDIANA PROFESSIONAL LICENSING AGENCY-SPEECH-LANGUAGE PATHOLOGY
12089398OtherAMERICAN SPEECH AND HEARING ASSOCIATION