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Individual

LEKRESIA OUTLAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5646 COUNTESS DR, FORT WAYNE, IN 46815-7412
(260) 602-5229
Mailing address
5646 COUNTESS DR, FORT WAYNE, IN 46815-7412
(260) 602-5229

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
104100000X
Social Worker
Primary

Other

Enumeration date
12/14/2022
Last updated
12/14/2022
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