Individual
HEATHER C SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADAC II
Contact information
Practice address
3282 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(812) 200-2789
Mailing address
9821 CRYSTAL COVE CT, NEW HAVEN, IN 46774-2803
(260) 310-9086
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C2-51331
IN
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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