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Organization
JOAN LOUISE PONTIUS
Active
Organization
JOAN LOUISE PONTIUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOAN LOUISE PONTIUS LMHC (THERAPIST)
(574) 360-3305
Entity
Organization
Contact information
Practice address
219 N DIXIE WAY, SUITE135, SOUTH BEND, IN 46637-3369
(574) 360-3305
(574) 271-3740
Mailing address
219 N DIXIE WAY, SUITE135, SOUTH BEND, IN 46637-3369
(574) 360-3305
(574) 271-3740
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IN
2084P0800X
Psychiatry Physician
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700138492
—
IN
Enumeration date
09/05/2013
Last updated
09/05/2013
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