Individual
ELIZABETH PICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
9417 SAINT JOE CENTER RD, FORT WAYNE, IN 46835-9259
(260) 485-3692
Mailing address
5333 MOONROCK CT, FORT WAYNE, IN 46804-4339
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003553A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88000405A
01-INDIVIDUAL
IN
Enumeration date
01/05/2018
Last updated
08/23/2019
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