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General NPI Number Information
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NPI Number | 1932962537
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Entity Type | Organization
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Legal Business Name | MADE TO THRIVE MENTAL HEALTH WELLNESS
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 6633 E STATE BLVD STE 125A
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City | FORT WAYNE
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State | IN
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Zip | 46815-7035
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Country | US
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Telephone | 260-900-2339
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Fax | 260-231-3374
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Provider Business Mailing Address
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Address Line | 6633 E STATE BLVD STE 125A
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City | FORT WAYNE
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State | IN
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Zip | 46815-7035
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Country | US
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Telephone | 260-900-2339
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Fax | 260-231-3374
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Authorized Official
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Title or Position | OWNER
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Name | DELANEY BAUMANN
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Credential | NP
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Telephone | 260-615-9149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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