Individual
AUDREY RENEE FELLOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.H.C
Contact information
Practice address
912 E LASALLE AVE, SOUTH BEND, IN 46617-2817
(574) 231-8000
(574) 231-8013
Mailing address
912 E LASALLE AVE, SOUTH BEND, IN 46617-2817
(574) 231-8000
(574) 231-8013
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003063A
IN
Other
Enumeration date
08/25/2017
Last updated
07/21/2022
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