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1124712484
KELLEN LEWIS
FORT WAYNE, IN
NPI
1124712484
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 88001951A)
Enumeration Date
2023-06-07
Last Update Date
2023-06-07
Business Address
KELLEN LEWIS
6202 CONSTITUTION DR
FORT WAYNE, IN 46804-1583
Phone number: 260-515-0522
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Mailing Address
KELLEN LEWIS
9712 SERPENTINE CV
FORT WAYNE, IN 46804-5238
Phone number: 260-515-0522
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