Basic Information
Provider Information
NPI: 1730776931
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRUEWING
FirstName: ALESIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2100 N HIGH ST
Address2:  
City: MUNCIE
State: IN
PostalCode: 473031817
CountryCode: US
TelephoneNumber: 7657165745
FaxNumber:  
Practice Location
Address1: 4870 E JACKSON ST
Address2:  
City: MUNCIE
State: IN
PostalCode: 473034432
CountryCode: US
TelephoneNumber: 7652549717
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/22/2020
LastUpdateDate: 12/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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