| Therese C Mihlbauer, Ph.d., Inc | |
|
4656 W Jefferson Blvd Suite 200 Fort Wayne IN 46804-6857 | |
| (260) 969-0915 | |
| (260) 969-0917 |
| Full Name | Therese C Mihlbauer, Ph.d., Inc |
|---|---|
| Speciality | Psychologist |
| Location | 4656 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Therese C Mihlbauer (CEO) |
| Authorized Official Contact | 2609690915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therese C Mihlbauer, Ph.d., Inc 4656 W Jefferson Blvd Suite 200 Fort Wayne IN 46804-6857 Ph: (260) 969-0915 | Therese C Mihlbauer, Ph.d., Inc 4656 W Jefferson Blvd Suite 200 Fort Wayne IN 46804-6857 Ph: (260) 969-0915 |
| NPI Number | 1770561847 |
|---|---|
| Provider Enumeration Date | 01/09/2006 |
| Last Update Date | 01/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770561847 | NPI | - | NPPES |
| 100081280 | Medicaid | IN | |
| 200730270 | Medicaid | IN | |
| 200667860 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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