Individual
EMILY ELIZABETH WHITACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
2250 LAKE AVE STE 100, FORT WAYNE, IN 46805-5352
(260) 225-8077
Mailing address
4033 ABOITE LAKE DR, FORT WAYNE, IN 46804-3909
(260) 228-1043
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99125060A
IN
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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