Individual
MRS. MARY THERESE EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9131 LIMA RD, FORT WAYNE, IN 46818-1803
(260) 489-2693
(260) 489-1495
Mailing address
9131 LIMA RD, FORT WAYNE, IN 46818-1803
(260) 489-2693
(260) 489-1495
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002170A
IN
231HA2400X
Assistive Technology Practitioner Audiologist
23002170A
IN
237600000X
Audiologist-Hearing Aid Fitter
23002170A
IN
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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