Provider Demographics
NPI:1104610575
Name:OBENCHAIN, MAUREEN BUTZ
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:BUTZ
Last Name:OBENCHAIN
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:KAROLE
Other - Last Name:BUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5342 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2522
Mailing Address - Country:US
Mailing Address - Phone:317-908-7223
Mailing Address - Fax:
Practice Address - Street 1:5342 E 72ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2522
Practice Address - Country:US
Practice Address - Phone:317-908-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist