Healthcare Provider Details

I. General information

NPI: 1326024431
Provider Name (Legal Business Name): GRETCHEN LYNN NEFF MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 CEDAR ST SUITE 405
SOUTH BEND IN
46617-2054
US

IV. Provider business mailing address

1609 RIVERSIDE DR APT. C
SOUTH BEND IN
46616-1619
US

V. Phone/Fax

Practice location:
  • Phone: 574-237-7878
  • Fax: 574-237-7879
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: