Interdisciplinary Diagnostic and Evaluation Center, Inc.
NPI #1093938102 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1093938102
- Entity Type
- Organization
- Organization Name
- Interdisciplinary Diagnostic and Evaluation Center, Inc.
- Primary Specialty
- Clinic/Center - Developmental Disabilities
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Jun 17, 2008
Practice Location
- Address
- 3030 LAKE AVE
- Address 2
- SUITE 7
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46805-5428
- Phone
- (260) 422-2838
Authorized Official
- Name
- MARILYN NATHAN, PH.D.
- Title
- CLINICAL DIRECTOR
- Phone
- (765) 284-9573
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Developmental Disabilities — Developmental Disabilities |
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