NPI 1063038453

Jacinto Thomas Fragoso, AUD

Practitioner Audiologist Avon, IN

Practice location

Address: 1115 Ronald Reagan Pkwy STE 254, Avon, IN 46123-6911
Phone: (317) 944-6467
Mailing address: 250 N Shadeland Ave, Indianapolis, IN 46219-4959

Registered specialties (3)

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence 23002773A (IN)

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Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence A.02322 (OH)

Registry record

NPI: 1063038453
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jun 2020
Record last updated: 14 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.