Individual
SAMANTHA SUE JOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9426 LIMA RD STE A, FORT WAYNE, IN 46818-8681
(260) 413-3235
Mailing address
9426 LIMA RD STE A, FORT WAYNE, IN 46818-8681
(260) 413-3235
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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