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Individual

MRS. MARY E SAILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3010 E STATE BLVD, SUITE 100, FORT WAYNE, IN 46805-4700
(260) 471-0632
(260) 471-3451
Mailing address
3010 E STATE BLVD, SUITE 100, FORT WAYNE, IN 46805-4700
(260) 471-0632
(260) 471-3451

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14060ASO
IN
101YM0800X
Mental Health Counselor
14060ASO
IN
106H00000X
Marriage & Family Therapist
14060ASO
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000006472
MPLAN
IN
01
0000000182311
ANTHME BCBS
IN
01
1336
PHP
IN
01
18231
ANTHEM HIP
IN
01
272066000
MAGELLAN
IN
01
448670
VALUE OPTIONS
IN
01
5816707
AETNA
IN
Enumeration date
05/19/2006
Last updated
01/04/2011
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