Individual provider · Type 1 NPI

Nicole Lynn Vesta Wade

Developmental Therapist · Fort Wayne, IN

NPI number 1225875669 Active

Practice location

2626 Saint Joe Center Rd
Fort Wayne, IN 46825-5042

Call (260) 487-0328 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1225875669

Nicole Lynn Vesta Wade's National Provider Identifier is 1225875669, issued on Jul 12, 2024. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 12, 2024.