Individual
TAYLOR NIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
6359 CONSTITUTION DR, FORT WAYNE, IN 46804-1547
(419) 890-5500
Mailing address
885 COMMERCE DR, PERRYSBURG, OH 43551-5267
(419) 330-5122
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33010502A
IN
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/02/2018
Last updated
03/12/2025
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