Individual
MS. SHARLENE KAY KOBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.T.S.
Contact information
Practice address
115 W BROADWAY ST, MISHAWAKA, IN 46545-6134
(574) 274-9049
(888) 647-0543
Mailing address
115 W BROADWAY ST, MISHAWAKA, IN 46545-6134
(574) 274-9049
(888) 647-0543
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
200948010A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200948010A
MEDICAID A D AND TBI WAIVER
IN
Enumeration date
07/09/2010
Last updated
07/09/2010
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