Individual
MRS. JENNIFER SUE HENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, MBA
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
Mailing address
6311 SHADOW RIDGE RUN, FORT WAYNE, IN 46804-4290
(260) 580-8974
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
36002067A
IN
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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