Individual
MS. MARCY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9426 LIMA RD STE A, FORT WAYNE, IN 46818-8681
(260) 497-0328
Mailing address
435 BERCADO CIR APT 27, MISHAWAKA, IN 46544-4148
(574) 440-5517
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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