Individual
MICHELLE HEIRONIMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
13703 SPLIT ROCK CV, FORT WAYNE, IN 46845-9134
(260) 255-4607
Mailing address
13703 SPLIT ROCK CV, FORT WAYNE, IN 46845-9134
(260) 255-4607
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39005178A
IN
Other
Enumeration date
07/15/2022
Last updated
02/12/2025
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