Individual
SAMARA FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
915 S CLINTON ST, FORT WAYNE, IN 46802-2601
(260) 422-5625
(260) 420-7382
Mailing address
517 N BROADWAY ST, BUTLER, IN 46721-1007
(260) 645-1481
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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