Organization
CEDAR CREEK PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ROBERT MOELLER (OWNER)
(260) 348-8031
Entity
Organization
Contact information
Practice address
1235 OAK TRAIL CT, FORT WAYNE, IN 46845-6120
(260) 348-8031
Mailing address
1235 OAK TRAIL CT, FORT WAYNE, IN 46845-6120
(260) 348-8031
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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