Provider Demographics
NPI:1386724540
Name:WESTROPP, FAY MARIE
Entity type:Individual
Prefix:
First Name:FAY
Middle Name:MARIE
Last Name:WESTROPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311-B WEST JEFFERSON BLVD.
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-6237
Mailing Address - Country:US
Mailing Address - Phone:260-432-2311
Mailing Address - Fax:260-432-2311
Practice Address - Street 1:7311 B WEST JEFFERSON BLVD.
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-6237
Practice Address - Country:US
Practice Address - Phone:260-432-2311
Practice Address - Fax:260-432-2311
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001915A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional