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NPI Code Detail

MEDICARE: MISS FLOIE J STOUDER L.C.S.W.

MEDICARE: MISS FLOIE J STOUDER L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34002611AIN
21041C0700XClinical Social Worker35000990AIN

General Provider Information

NPI Number : 1619034139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS FLOIE J STOUDER L.C.S.W.
Provider Business Mailing Address
First Line : 8031 SWEETFERN LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-3440
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1415 MAGNAVOX WAY
Second Line : SUITE 120
City : FORT WAYNE
State : IN
Zip : 46804-1565
Country : US
Telephone Number : 260-705-2223
Fax Number : 260-483-0836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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Directions to “ MISS FLOIE J STOUDER L.C.S.W.” Practice Location

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