| Tina Huffman Sole Mbr | |
|
2323 111 W. Berry St. Fort Wayne IN 46802 | |
| (260) 557-1329 | |
| Not Available |
| Full Name | Tina Huffman Sole Mbr |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2323 111 W. Berry St., Fort Wayne, Indiana |
| Authorized Official Name and Position | Tina Marie Huffman (OWNER) |
| Authorized Official Contact | 2605571329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Huffman Sole Mbr 429 E. Dupont Rd. Pmb 152 Fort Wayne IN 46825 Ph: () - | Tina Huffman Sole Mbr 2323 111 W. Berry St. Fort Wayne IN 46802 Ph: (260) 557-1329 |
| NPI Number | 1699260182 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 06/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699260182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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