| Life Story Counseling Llc | |
|
3290 Mallard Cove Ln Fort Wayne IN 46804-2883 | |
| (260) 271-5026 | |
| Not Available |
| Full Name | Life Story Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3290 Mallard Cove Ln, Fort Wayne, Indiana |
| Authorized Official Name and Position | Veronica R Sanderson (OWNER) |
| Authorized Official Contact | 2602715026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Story Counseling Llc 3290 Mallard Cove Ln Fort Wayne IN 46804-2883 Ph: (260) 271-5026 | Life Story Counseling Llc 3290 Mallard Cove Ln Fort Wayne IN 46804-2883 Ph: (260) 271-5026 |
| NPI Number | 1063094613 |
|---|---|
| Provider Enumeration Date | 04/23/2021 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063094613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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