Healthcare Provider Details

I. General information

NPI: 1295653921
Provider Name (Legal Business Name): JESSICA ENGELS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3565 S STATE ROAD 13
WABASH IN
46992-9162
US

IV. Provider business mailing address

3565 S STATE ROAD 13
WABASH IN
46992-9162
US

V. Phone/Fax

Practice location:
  • Phone: 260-563-8453
  • Fax:
Mailing address:
  • Phone: 260-563-8453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33013845A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: