Individual
DAVID A KININGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
6334 CONSTITUTION DR., FORT WAYNE, IN 46804-4680
(260) 260-1209
(260) 782-3215
Mailing address
6334 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 209-1209
(260) 782-3215
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001795A
IN
Other
Enumeration date
10/10/2006
Last updated
02/21/2020
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