Individual
KELSEY E. TIERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3478 STELLHORN RD, FORT WAYNE, IN 46815-4630
(260) 452-5336
(260) 387-5075
Mailing address
1817 BEINEKE RD, FORT WAYNE, IN 46808-1627
(260) 310-3266
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
11/10/2021
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