DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MACKENNA LEE VANDERTUIN

Active Sole Proprietor

MACKENNA LEE VANDERTUIN is a Early Intervention Provider Agency healthcare provider located in DEMOTTE, Indiana. NPI 1447872197 is currently active in the NPPES registry. Verify at CMS.

Early Intervention Provider Agency · DEMOTTE, IN

Registration Details

NPI Number
1447872197
Provider Type
Individual
Gender
Female
NPI Issued
May 15, 2020 (6.2745630828896 yrs)
Last Updated
May 15, 2020
Sole Proprietor
Yes

Practice Information

Address
400 11TH CIRCLE SE
DEMOTTE, IN, 46310
Browse IN providers · Browse ZIP 46310
Phone
2197427641
Primary Specialty
Early Intervention Provider Agency
252Y00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.