Individual
MELINDA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-7500
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
(260) 266-6013
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004261A
IN
Other
Enumeration date
07/18/2016
Last updated
10/20/2022
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