Mayle, Amanda L
Mayle, Amanda L is an individual health care provider with primary practice located at 11141 Parkview Plaza Dr Ste 210 , Fort Wayne IN 46845-1714. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mayle, Amanda L can be contacted via phone (260) 266-5400.Contact Information
Primary practice address
11141 Parkview Plaza Dr Ste 210
Fort Wayne IN 46845-1714
Phone: (260) 266-5400
Fax: (260) 266-5409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20042046A | Indiana |
Profile Details
| NPI number | 1003865395 |
|---|---|
| LBN Legal business name | Mayle, Amanda L |
| Credentials | PSY.D., HSPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2006 |
| Last updated | Oct 11th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003865395 | NPPES |
| Indiana | MEDICAID | 200802600 |
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