Individual
ELLA ANGELIQUE D CAUSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6030 E STATE BLVD, FORT WAYNE, IN 46815-7639
(260) 452-0554
Mailing address
6030 E STATE BLVD, FORT WAYNE, IN 46815-7639
(260) 452-0554
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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