Individual
LYNN MARIE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LCSW LMFT
Contact information
Practice address
3010 E STATE BLVD, FORT WAYNE, IN 46805
(260) 471-2300
(260) 471-2778
Mailing address
3010 E STATE BLVD, FORT WAYNE, IN 46805
(260) 471-2300
(260) 471-2778
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002494A
IN
106H00000X
Marriage & Family Therapist
35001088A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200410870
—
IN
Enumeration date
09/01/2006
Last updated
02/09/2015
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