Provider Demographics
NPI:1588985634
Name:WARD, PATRICIA SUE (SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:SUE
Last Name:WARD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:SUE
Other - Last Name:CREECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1325 E COUNTY ROAD 100 S
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-7656
Mailing Address - Country:US
Mailing Address - Phone:812-701-4067
Mailing Address - Fax:812-346-1305
Practice Address - Street 1:1325 E COUNTY ROAD 100 S
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-7656
Practice Address - Country:US
Practice Address - Phone:812-701-4067
Practice Address - Fax:812-346-1305
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22000371A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist