| Wetzel Therapy Inc | |
|
17903 State Road 23 Suite #3 South Bend IN 46635-1642 | |
| (574) 243-7730 | |
| (574) 243-7735 |
| Full Name | Wetzel Therapy Inc |
|---|---|
| Speciality | Social Worker |
| Location | 17903 State Road 23, South Bend, Indiana |
| Authorized Official Name and Position | Brenda E Wetzel (SOLE PROVIDER) |
| Authorized Official Contact | 5742437730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wetzel Therapy Inc 17903 State Road 23 Suite #3 South Bend IN 46635-1642 Ph: (574) 243-7730 | Wetzel Therapy Inc 17903 State Road 23 Suite #3 South Bend IN 46635-1642 Ph: (574) 243-7730 |
| NPI Number | 1801192026 |
|---|---|
| Provider Enumeration Date | 02/05/2011 |
| Last Update Date | 04/23/2014 |
| Medicare PECOS PAC ID | 9234310228 |
|---|---|
| Medicare Enrollment ID | O20110224000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801192026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34001342A (Indiana) | Primary |
| Provider Name | Brenda E Wetzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851368195 PECOS PAC ID: 9739360736 Enrollment ID: I20110224000109 |
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