Doctor Name: | INDU VAIDYANATHAN |
NPI Number: | 1548640550 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 11180 |
Business Practice Address: | 4350 Main St Ste 217 Harrisburg, NC - 280757448 |
Business Phone Number: | 7045599409 |
Business Fax Number: | |
Mailing Address: | 4258 Highway 49 S Unit 554, HARRISBURG |
State: | NC |
Postal Code: | 280750137 |
Phone Number: | 7045599409 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 11180 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |