Individual
JESSICA EILEEN POLUBINSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3702 RUPP DR STE 5, FORT WAYNE, IN 46815-4526
(260) 615-3360
Mailing address
1129 RIVERMET AVE, FORT WAYNE, IN 46805-4232
(260) 602-1069
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003405A
IN
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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