Individual
STEPHANIE BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2013 S ANTHONY BLVD, FORT WAYNE, IN 46803-3609
(260) 417-4801
Mailing address
PO BOX 10156, FORT WAYNE, IN 46850-0156
(260) 255-3514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001903A
IN
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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