Organization
BROOKE SELLHORN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE N SELLHORN LMFT (OWNER)
(260) 409-0609
Entity
Organization
Contact information
Practice address
9417 SAINT JOE CENTER RD, FORT WAYNE, IN 46835-9259
(260) 485-3692
Mailing address
3717 OAKHURST DR, FORT WAYNE, IN 46815-6238
(260) 409-0609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700221330
01 - INDIVIDUAL
IN
Enumeration date
01/04/2018
Last updated
01/04/2018
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