Individual
BRYAN WILLIAM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3458
(260) 481-2700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000162A
IN
106H00000X
Marriage & Family Therapist
Primary
35001696A
IN
Other
Enumeration date
03/31/2011
Last updated
04/11/2025
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