Organization
JOURNEYMAKERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYNE S ANDERSOHN (OWNER)
(574) 584-4571
Entity
Organization
Contact information
Practice address
501 W BRISTOL ST, ELKHART, IN 46514-2964
(574) 584-4571
Mailing address
501 W BRISTOL ST, ELKHART, IN 46514-2964
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3901564A
LICENSE
—
Enumeration date
06/04/2019
Last updated
06/04/2019
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