Individual
RHONDA S JACKISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.H.C.
Contact information
Practice address
813 AIRPORT NORTH OFFICE PARK, FORT WAYNE, IN 46825-6711
(260) 489-8391
(260) 489-6952
Mailing address
813 AIRPORT NORTH OFFICE PARK, FORT WAYNE, IN 46825-6711
(260) 489-8391
(260) 489-6952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000186A
IN
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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