Individual
MABLE-GENE LOUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5111 N BEND DR, FORT WAYNE, IN 46804-1753
(260) 436-8807
Mailing address
1107 E 28TH ST, MARION, IN 46953-3736
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22107337
IN
225A00000X
Music Therapist
—
—
253Z00000X
In Home Supportive Care Agency
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450230-06
BCTMB
IN
01
—
LCEU0002762
CERTIFICATIONS BCTMB
IN
01
—
MT22107337
IN STATE LICENSE
IN
Enumeration date
08/22/2022
Last updated
08/22/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us