Individual
BONNIE ELIZABETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCACA
Contact information
Practice address
4656 W JEFFERSON BLVD STE 285, FORT WAYNE, IN 46804-6838
(260) 255-4664
Mailing address
4656 W JEFFERSON BLVD STE 285, FORT WAYNE, IN 46804-6838
(260) 255-4664
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34012776A
IN
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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