Individual
MARJORIE L HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2330 BEACON ST, SUITE 105, FORT WAYNE, IN 46805-3852
(260) 602-8009
Mailing address
2330 BEACON ST, SUITE 105, FORT WAYNE, IN 46805-3852
(260) 602-8009
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001539A
IN
Other
Enumeration date
12/21/2009
Last updated
12/21/2009
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