Richardson, Mary
Richardson, Mary is an sole proprietor health care provider with primary practice located at 5930 Hallowell Pl , Fort Wayne IN 46815-6214. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Richardson, Mary can be contacted via phone (260) 409-0687.Contact Information
Primary practice address
5930 Hallowell Pl
Fort Wayne IN 46815-6214
Phone: (260) 409-0687
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 22004744A | Indiana |
Profile Details
| NPI number | 1962964064 |
|---|---|
| LBN Legal business name | Richardson, Mary |
| Credentials | MA CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 5th, 2019 |
| Last updated | Apr 5th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962964064 | NPPES |
| Indiana | Other | 12147615 | ASHA |
| Indiana | Other | 22004744A | ASHA |
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