Organization · Type 2 NPI
Mary Rose Lcsw, LLC
Mental Health Clinic/Center (Including Community Mental Health Center) · Fort Wayne, IN
NPI number
1083399869
Active
Practice location
1732 S Hadley Rd
Fort Wayne, IN 46804-1458
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
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About NPI 1083399869
Mary Rose Lcsw, LLC's National Provider Identifier is 1083399869, issued on Jun 19, 2023. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Fort Wayne, IN. The record was last updated on May 5, 2024.