Individual
MISS KIT J CORPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHCA
Contact information
Practice address
7230 ENGLE RD STE 304, FORT WAYNE, IN 46804-2209
(260) 483-2400
(260) 960-9361
Mailing address
7230 ENGLE RD STE 304, FORT WAYNE, IN 46804-2209
(260) 483-2400
(260) 960-9361
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000634A
IN
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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