Organization
MARY ROSE LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ROSE DRAPER LCSW (OWNER)
(260) 438-4905
Entity
Organization
Contact information
Practice address
1732 S HADLEY RD, FORT WAYNE, IN 46804-1458
(260) 438-4905
Mailing address
1732 S HADLEY RD, FORT WAYNE, IN 46804-1458
(260) 438-4905
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/19/2023
Last updated
05/05/2024
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