Miracle, Wayne
Miracle, Wayne is an sole proprietor health care provider with primary practice located at 413 S. Liberty St. , Muncie IN 47305-2341. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Miracle, Wayne can be contacted via phone (765) 288-8586.Contact Information
Primary practice address
413 S. Liberty St.
Muncie IN 47305-2341
Phone: (765) 288-8586
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X |
Profile Details
| NPI number | 1982717385 |
|---|---|
| LBN Legal business name | Miracle, Wayne |
| Credentials | ED.D. HSPP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Oct 18th, 2010 - about 15 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 | 1982717385 | NPPES |
| Indiana | MEDICAID | 100333760 | |
| Indiana | Other | 000000186190 | |
| Indiana | Other | 112439000 |
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