Individual
GLENIS A SUNDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. ED; LMFT
Contact information
Practice address
1818 CAREW ST STE 320, FORT WAYNE, IN 46805-4764
(260) 373-5890
(260) 422-8444
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001823A
IN
Other
Enumeration date
03/01/2012
Last updated
06/13/2019
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