Nicole Lynn Vesta Wade

NPI #1225875669 in Fort Wayne, Indiana

Provider Information

NPI Number: 1225875669
Entity Type: Individual
Name: Nicole Lynn Vesta Wade
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Developmental Therapist
Enumeration Date: Jul 12, 2024
Last Updated: Jul 12, 2024

Practice Location

Address: 2626 SAINT JOE CENTER RD
City: Fort Wayne
State: Indiana
ZIP Code: 46825-5042
Phone: (260) 487-0328

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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