Individual
MISS GRACE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 450-6671
Mailing address
1519 STABLEFORD DR, FORT WAYNE, IN 46845-2029
(260) 450-6671
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/23/2022
Last updated
11/13/2024
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