Provider Demographics
NPI:1720264054
Name:NAGEL, TRISHA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:
Last Name:NAGEL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:5302 SKIPPING STONE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-5043
Mailing Address - Country:US
Mailing Address - Phone:317-784-7034
Mailing Address - Fax:
Practice Address - Street 1:5302 SKIPPING STONE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-5043
Practice Address - Country:US
Practice Address - Phone:317-784-7034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003546A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist