Organization
BONNIE KISER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE KISER LMFT (MARRIAGE AND FAMILY THERAPIST)
(260) 710-5651
Entity
Organization
Contact information
Practice address
10315 DAWSONS CREEK BLVD, FORT WAYNE, IN 46825-1912
(260) 387-6340
(260) 387-6984
Mailing address
8121 HANAUER RD, FORT WAYNE, IN 46818-1897
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
35001593A
IN
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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