| Doctor Name: | NANDHAKUMAR RADHAKRISHNAN |
| NPI Number: | 1184911174 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 2011001490 |
| Business Practice Address: | 1101 Hospital Drive Columbia, MO - 652057687 |
| Business Phone Number: | 5738827903 |
| Business Fax Number: | 5738844607 |
| Mailing Address: | Po Box 7687, COLUMBIA |
| State: | MO |
| Postal Code: | 652120001 |
| Phone Number: | 5738822259 |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2011 |
| NPI Last Update Date: | 03/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2011001490 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |