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NPI Code Detail

MEDICARE: ANGEL NESS M.S.

MEDICARE: ANGEL NESS M.S.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093104069
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEL NESS M.S.
Provider Business Mailing Address
First Line : 3842 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-471-2300
Fax Number : 260-471-2778
Provider Business Practice Location Address
First Line : 3842 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-471-2300
Fax Number : 260-471-2778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2015
Last Update Date : 01/14/2015

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Directions to “ ANGEL NESS M.S.” Practice Location

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