Mary Colleen Kiesel

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22002695A Issued in IN

Practice address

404 W Willow Rd
Dale, IN 47523-8947

Phone

(812) 937-4489

NPI assigned

Dec 10, 2012

Last updated

Dec 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1992040489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W WILLOW RD",
            "city": "DALE",
            "state": "IN",
            "postal_code": "475238947",
            "telephone_number": "812-937-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W WILLOW RD",
            "city": "DALE",
            "state": "IN",
            "postal_code": "475238947",
            "telephone_number": "812-937-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESEL",
        "first_name": "MARY",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002695A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayci Brenae Howe, RBT
• Ashraf Jewell, PTA
• Kimberly Renee Jochem, OTR
• Paula J Jochim, FNP
• Les John Kiesel, OTR
• Deborah Konerding, PTA
• Halle Marie Laswell, RBT
• Lifespring, Inc (Dale Community Medical Services)
• Lifespring, Inc (LifeSpring Health Systems)
• Caymon Ariez Lowery

• Speech-Language Pathologist in Dale, IN
• Providers in Dale, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.