Individual
JESSICA FABIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6131 N CLINTON ST, FORT WAYNE, IN 46825-4905
(260) 459-6040
Mailing address
5441 E 400 S, LAOTTO, IN 46763-9724
(260) 452-4020
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43370
IN
Other
Enumeration date
07/24/2020
Last updated
09/23/2022
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