Individual
KIMBERLY D FAROUKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815
(260) 483-9081
(260) 483-9196
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9550
(512) 575-8028
(512) 772-4550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006395A
IN
Other
Enumeration date
03/30/2012
Last updated
01/22/2019
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