Individual
LISA ANNE KOSNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2046 E DUPONT RD, FORT WAYNE, IN 46825-1583
(260) 615-6020
Mailing address
2046 E DUPONT RD, FORT WAYNE, IN 46825-1583
(260) 615-6020
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005868A
IN
1041C0700X
Clinical Social Worker
6801046879
MI
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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