Provider Demographics
NPI:1932322146
Name:ST. JOSEPH INSTITUTE FOR THE DEAF INDIANAPOLIS
Entity Type:Organization
Organization Name:ST. JOSEPH INSTITUTE FOR THE DEAF INDIANAPOLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-471-8560
Mailing Address - Street 1:9192 WALDEMAR RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1131
Mailing Address - Country:US
Mailing Address - Phone:317-471-8560
Mailing Address - Fax:
Practice Address - Street 1:9192 WALDEMAR RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1131
Practice Address - Country:US
Practice Address - Phone:317-471-8560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty