Individual
MIRANDA FENCL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
6655 E US HIGHWAY 36, AVON, IN 46123-8923
(888) 714-1927
(317) 272-0807
Mailing address
5101 E US HIGHWAY 36 STE 100, AVON, IN 46123-6646
(888) 714-1927
(317) 745-9565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34008074A
IN
Other
Enumeration date
06/21/2015
Last updated
04/02/2018
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