Individual
MR. JOHN WHEATON LINK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS LMFT
Contact information
Practice address
2200 LAKE AVE, SUITE 130, FORT WAYNE, IN 46805-5397
(260) 438-9540
Mailing address
2200 LAKE AVE, SUITE 130, FORT WAYNE, IN 46805-5397
(260) 438-9540
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35000358A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAQH PROVIDER
11506176
IN
01
—
LICENSE NUMBER
35000358A
IN
Enumeration date
03/10/2007
Last updated
07/08/2007
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