Provider Demographics
NPI:1437961638
Name:DEWITT, MARIAH
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:DEWITT
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 1:107 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CHRISNEY
Mailing Address - State:IN
Mailing Address - Zip Code:47611-9709
Mailing Address - Country:US
Mailing Address - Phone:812-646-8394
Mailing Address - Fax:
Practice Address - Street 1:107 E SPRING ST
Practice Address - Street 2:
Practice Address - City:CHRISNEY
Practice Address - State:IN
Practice Address - Zip Code:47611-9709
Practice Address - Country:US
Practice Address - Phone:812-646-8394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator