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Contact Information

MARY PEDTKE
530 BENTEE WES COURT
EVANSVILLE, IN47715
 Phone: 812-401-1836
 Fax: 812-401-8013
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for MARY PEDTKE · (Female)

NPI Number 1285912618
Status Active
Credentials
Entity Individual
Enumeration date 08/02/2011
Last updated 10/23/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 34004163A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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