Individual
ANNA KAYLEEN ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2622 LAKE AVE STE 1, FORT WAYNE, IN 46805-5410
(260) 299-3160
(260) 299-3159
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34012201A
IN
Other
Enumeration date
12/08/2022
Last updated
09/17/2025
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