Individual
PHAECIA A. WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4406 ATWOOD DR, FORT WAYNE, IN 46806-4916
(260) 600-7045
Mailing address
4406 ATWOOD DR, FORT WAYNE, IN 46806-4916
(260) 600-7045
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
IN
1041C0700X
Clinical Social Worker
Primary
34009215A
IN
Other
Enumeration date
05/02/2017
Last updated
04/06/2021
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