Individual
KELLY ANN BAUMGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HSPP
Contact information
Practice address
2100 GOSHEN RD, FORT WAYNE, IN 46808-1493
(260) 471-3500
(260) 471-4263
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7169
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043122A
IN
Other
Enumeration date
12/23/2010
Last updated
03/17/2018
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