Individual
NANCY SANSOM RATHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACCC-SLP
Contact information
Practice address
3320 E STATE BLVD, FORT WAYNE, IN 46805-5601
(260) 484-3120
(260) 969-0104
Mailing address
3320 E STATE BLVD, FORT WAYNE, IN 46805-5601
(260) 484-3120
(260) 969-0104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001327A
IN
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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