Provider Demographics
NPI:1205559275
Name:SHREVE, RITA ANN
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ANN
Last Name:SHREVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 E CLIFTON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47320-9766
Mailing Address - Country:US
Mailing Address - Phone:765-289-1751
Mailing Address - Fax:
Practice Address - Street 1:1613 W RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-1012
Practice Address - Country:US
Practice Address - Phone:765-285-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist