Provider Demographics
NPI:1811724701
Name:NUNEZ MENDEZ, ANGELICA (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:
Last Name:NUNEZ MENDEZ
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 1:8204 E HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-1566
Mailing Address - Country:US
Mailing Address - Phone:787-501-8429
Mailing Address - Fax:
Practice Address - Street 1:1601 E 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-1901
Practice Address - Country:US
Practice Address - Phone:317-226-4274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN14112487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist