IndividualActive
Mackenna Vandertuin
NPI 1447872197 · Early Intervention Provider Agency · Demotte, IN
Provider details
- NPI number
- 1447872197
- Entity type
- Individual
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Agencies
Practice location
400 11th Circle Se
Demotte, IN 46310
Phone: (219) 742-7641
Approximate (ZIP-level) locationGet directions
Mailing address
400 11th Circle Se
Demotte, IN 46310
Registry dates
- Enumerated
- 2020-05-15
- Last updated
- 2020-05-15
- Certified
- 2020-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.