Individual
GARY YOUNGHANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
3514 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 492-5500
Mailing address
5206 FERNWOOD AVE, FORT WAYNE, IN 46809-1932
(260) 747-3095
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001689A
IN
Other
Enumeration date
01/27/2010
Last updated
01/28/2010
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