MEDICARE: FAY MARIE WESTROPP

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
1	101YP2500X	Professional Counselor	39001915A	IN

General Provider Information

NPI Number	:	1386724540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAY MARIE WESTROPP

Provider Business Mailing Address
First Line	:	7311-B WEST JEFFERSON BLVD.
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-6237
Country	:	US
Telephone Number	:	260-432-2311
Fax Number	:	260-432-2311

Provider Business Practice Location Address
First Line	:	7311 B WEST JEFFERSON BLVD.
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-6237
Country	:	US
Telephone Number	:	260-432-2311
Fax Number	:	260-432-2311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	04/07/2008

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