Individual
MARIAH FASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 ADAMS ST STE 204, CARMEL, IN 46032-7838
(317) 456-2052
Mailing address
708 ADAMS ST STE 204, CARMEL, IN 46032-7838
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012061A
IN
Other
Enumeration date
04/19/2025
Last updated
04/19/2025
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