Individual
KALEY SOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 ILLINOIS RD, FORT WAYNE, IN 46804-1208
(260) 240-4945
Mailing address
3528 BASS RD, FORT WAYNE, IN 46808-2929
(517) 745-7071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001989A
IN
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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