Individual
MARY ELLEN SPAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
380 TRATEBAS RD, VALPARAISO, IN 46383-9752
(219) 405-3210
Mailing address
2843 CALUMET AVE, #233, VALPARAISO, IN 46383-2605
(219) 465-1358
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042149A
IN
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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