Individual
MATT HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
505 N WABASH AVE, MARION, IN 46952-2608
(765) 662-3971
(765) 668-6718
Mailing address
505 N WABASH AVE, MARION, IN 46952-2608
(765) 662-3971
(765) 668-6718
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001366A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123170A
—
IN
Enumeration date
05/20/2008
Last updated
05/20/2008
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