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Individual

DR. JAMES A. DANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.MIN.

Contact information

Practice address
300 W WAYNE ST, FORT WAYNE, IN 46802-3608
(260) 422-8556
(260) 422-8558
Mailing address
6612 TRALEE CT, FORT WAYNE, IN 46835-9662
(260) 486-1089

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000394A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00055
ICAC-II
IN
01
39000394A
MENTAL HEALTH LICENSE
IN
Enumeration date
01/29/2007
Last updated
05/14/2008
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