Individual
DANIELLE M RUPNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, BC, OWNER
Contact information
Practice address
1922 KIMBERLITE PL, FORT WAYNE, IN 46804-5225
(260) 479-7712
Mailing address
1922 KIMBERLITE PL, FORT WAYNE, IN 46804-5225
(260) 479-7712
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10000772
IN
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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