Individual
DEBORAH KAY MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Mailing address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 485-2546
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007982A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
945300085
MEDICARE PTAN
IN
Enumeration date
01/09/2013
Last updated
08/10/2022
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