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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1982717385 NPPES
Indiana MEDICAID 100333760
Indiana Other 000000186190
Indiana Other 112439000

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