Provider Demographics
NPI:1053929695
Name:MEANS, AUDREY
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:MEANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9997 LAKEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9560
Mailing Address - Country:US
Mailing Address - Phone:765-914-1402
Mailing Address - Fax:
Practice Address - Street 1:16635 CENTERFIELD DR STE 103
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7745
Practice Address - Country:US
Practice Address - Phone:907-694-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist