Individual
MRS. BERNADINE PAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.ED, BSW
Contact information
Practice address
315 AIRPORT NORTH OFFICE PARK, RAJ CLINICS, FORT WAYNE, IN 46825
(260) 490-8352
Mailing address
6602 SELKIRK DR, FORT WAYNE, IN 46816-4186
(260) 447-5456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13438
—
IN
Enumeration date
11/19/2012
Last updated
11/19/2012
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