Individual
MS. CREATION DESAUTELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
300 E MULBERRY ST, KOKOMO, IN 46901-4765
(406) 465-2596
Mailing address
300 E MULBERRY ST, KOKOMO, IN 46901-4765
(406) 465-2596
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35002278A
IN
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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