Individual
SU MAR YAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
410 W CONCORD LN, FORT WAYNE, IN 46807-3525
(720) 936-0758
Mailing address
410 W CONCORD LN, FORT WAYNE, IN 46807-3525
(720) 936-0758
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
24-0178031
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300099479
—
IN
Enumeration date
12/29/2025
Last updated
12/29/2025
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