Deraedt, Mary

Deraedt, Mary is an individual health care provider with primary practice located at 610 Main St , Lafayette IN 47901-1451. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Deraedt, Mary can be contacted via phone (765) 423-2638.

Contact Information

Primary practice address
610 Main St Lafayette IN 47901-1451
Phone: (765) 423-2638
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 39001884A Indiana

Profile Details

NPI number 1194910836
LBN Legal business name Deraedt, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2007
Last updated Sep 10th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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