Individual
VANDER FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2827 NORTHGATE BLVD, FORT WAYNE, IN 46835-2900
(214) 442-4000
Mailing address
1755 WITTINGTON PL, #175, DALLAS, TX 75234-1927
(214) 442-4000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005152A
IN
235Z00000X
Speech-Language Pathologist
3844
KY
235Z00000X
Speech-Language Pathologist
SP.9169
OH
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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