Organization
KIMBERLY LONEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LONEY LMHC (OWNER)
(260) 418-2029
Entity
Organization
Contact information
Practice address
3106 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 418-2029
Mailing address
3106 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 418-2029
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201137000A
—
IN
Enumeration date
01/26/2021
Last updated
01/26/2021
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