Individual
KIMBERLY ANN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5310 MERCHANDISE DR., FORT WAYNE, IN 46814
(260) 705-4395
Mailing address
5310 MERCHANDISE DR, FORT WAYNE, IN 46825-5140
(260) 705-4395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
886385907
IN
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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