Provider Demographics
NPI:1295981488
Name:RARDIN, SUSAN ELAINE (MA)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELAINE
Last Name:RARDIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E 86TH ST
Mailing Address - Street 2:#35
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1850
Mailing Address - Country:US
Mailing Address - Phone:317-731-5386
Mailing Address - Fax:317-731-5423
Practice Address - Street 1:911 E 86TH ST
Practice Address - Street 2:#35
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1850
Practice Address - Country:US
Practice Address - Phone:317-731-5386
Practice Address - Fax:317-731-5423
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001937A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist