Organization
KOHOPELLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENDRA S O'CONNOR LCSW, LCAC (OWNER)
(260) 715-8767
Entity
Organization
Contact information
Practice address
6201 CONSTITUTION DR, FORT WAYNE, IN 46804-1517
(260) 715-8767
Mailing address
6201 CONSTITUTION DR, FORT WAYNE, IN 46804-1517
(260) 715-8767
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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