Individual
LINDA HAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 BROADWAY, FORT WAYNE, IN 46802-2149
(260) 425-3620
Mailing address
800 BROADWAY, FORT WAYNE, IN 46802-2149
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000019A
IN
101YM0800X
Mental Health Counselor
Primary
39001312A
IN
104100000X
Social Worker
33001275A
IN
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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