Individual
BETH ANN KOENEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
(260) 744-4326
(260) 744-0188
Mailing address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34010829A
IN
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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