Individual
MRS. CAROLYN RICHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW ACSW
Contact information
Practice address
2121 LAKE AVE, VA NORTHERN INDIANA, FORT WAYNE, IN 46808
(260) 426-5431
(260) 460-1481
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805
(260) 426-5431
(260) 460-1481
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34003654A
IN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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