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Individual

CHARLES PHILIP REDWINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT, LAC

Contact information

Practice address
126 W COLUMBIA ST, SUITE 300, FORT WAYNE, IN 46802-1719
(260) 203-9185
(260) 203-9187
Mailing address
126 W COLUMBIA ST, SUITE 300, FORT WAYNE, IN 46802-1719
(260) 203-9185
(260) 203-9187

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35000968A
IN

Other

Enumeration date
12/10/2009
Last updated
10/05/2015
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