Provider Demographics
NPI:1295487809
Name:SCHWARZKOPF, GRETA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:SCHWARZKOPF
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 1:8518 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-2024
Mailing Address - Country:US
Mailing Address - Phone:317-450-2868
Mailing Address - Fax:
Practice Address - Street 1:5841 THUNDERBIRD RD STE I
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-4792
Practice Address - Country:US
Practice Address - Phone:317-723-6089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004292A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist