Individual
JACQUELINE BRANDY VEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, LCAC
Contact information
Practice address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
(260) 744-4326
Mailing address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
(260) 744-4326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001621A
IN
106H00000X
Marriage & Family Therapist
Primary
35002029A
IN
Other
Enumeration date
08/09/2016
Last updated
06/18/2024
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