Provider Demographics
NPI:1578338604
Name:FUCHS-SOBIECK, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FUCHS-SOBIECK
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 1:2924 SOUTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1622
Mailing Address - Country:US
Mailing Address - Phone:260-205-2860
Mailing Address - Fax:
Practice Address - Street 1:2924 SOUTHWAY DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1622
Practice Address - Country:US
Practice Address - Phone:260-205-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist