Individual
LAURA C. MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 BARR ST, FORT WAYNE, IN 46802-3502
(260) 467-1163
Mailing address
1200 BARR ST, FORT WAYNE, IN 46802-3502
(260) 467-1163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001251A
IN
101YM0800X
Mental Health Counselor
39001213A
IN
103TS0200X
School Psychologist
Primary
1579519
IN
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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