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Individual

KERRY A FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1008 W OHIO ST, ROCKVILLE, IN 47872-1536
(765) 569-5350
(765) 569-5340
Mailing address
1008 W OHIO ST, ROCKVILLE, IN 47872-1536
(765) 569-5350
(765) 569-5340

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99096255A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
99096255A
LICENSE
IN
Enumeration date
11/20/2019
Last updated
11/20/2019
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