Individual
CHARLES BALKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7311A W JEFFERSON BLVD, FORT WAYNE, IN 46804-6237
(260) 471-8033
(260) 471-8107
Mailing address
7311A W JEFFERSON BLVD, FORT WAYNE, IN 46804-6237
(260) 471-8033
(260) 471-8107
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042479A
IN
Other
Enumeration date
10/23/2013
Last updated
07/08/2022
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