Organization
BUILDING A STRONGER FAMILY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHON NEAL WATTLEY (C.E.O)
(260) 797-5892
Entity
Organization
Contact information
Practice address
201 E RUDISILL BLVD STE B102, FORT WAYNE, IN 46806-1756
(260) 797-5892
Mailing address
921 E DUPONT RD # 909, FORT WAYNE, IN 46825-1551
(260) 797-5892
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/18/2022
Last updated
03/01/2022
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