Individual
ROBERT VANDERWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LMHC
Contact information
Practice address
1818 WENT AVE, MISHAWAKA, IN 46545
(574) 254-0229
(574) 254-0188
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002492A
IN
Other
Enumeration date
09/10/2013
Last updated
07/31/2018
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