Individual
STEPHEN MICHAEL O'SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3407 ROLSTON ST, FORT WAYNE, IN 46805-1535
(260) 609-3360
Mailing address
3407 ROLSTON ST, FORT WAYNE, IN 46805-1535
(260) 609-3360
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
85000019A
IN
Other
Enumeration date
02/27/2011
Last updated
02/27/2011
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