Individual
LANETTE L FRAVEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6913 BLAKE DR, FORT WAYNE, IN 46804-1013
(260) 223-2942
Mailing address
6913 BLAKE DR, FORT WAYNE, IN 46804-1013
(260) 223-2942
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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