Individual
KATELYN ANN THAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2629 DEERWOOD DR, FORT WAYNE, IN 46825-3919
(260) 530-3240
Mailing address
2629 DEERWOOD DR, FORT WAYNE, IN 46825-3919
(260) 530-3240
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33010658A
IN
1041C0700X
Clinical Social Worker
Primary
34011567A
IN
Other
Enumeration date
10/12/2022
Last updated
12/02/2025
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