JACOB M FAWLEY

FORT WAYNE, IN
NPI1528727807
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: IN  39002631A)
Enumeration Date2021-12-14
Last Update Date2021-12-14
Business Address
JACOB M FAWLEY
4150 ILLINOIS RD
FORT WAYNE, IN 46804-1208
Phone number: 260-702-3752
Mailing Address
JACOB M FAWLEY
4150 ILLINOIS RD
FORT WAYNE, IN 46804-1208
Phone number:
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