person
Jacob M Fawley
Mental Health Counselor in Fort Wayne, Indiana
NPI 1528727807

Jacob M Fawley is a Mental Health Counselor based in Fort Wayne, IN and is specialized in Mental Health. Jacob M Fawley practices in Fort Wayne, IN. The NPI Number for Jacob M Fawley is 1528727807 and holds a License No. 39002631A (Indiana).

The current practice location address for Jacob M Fawley is 4150 Illinois Rd, Fort Wayne, IN and can be reached out via phone at 260-702-3752 and via fax at 260-702-3752.

Location: 4150 Illinois Rd, Fort Wayne, IN, 46804-1208
person
Provider Profile Details
NPI Number
1528727807
Provider Name
Jacob M Fawley
Credential
Provider Entity Type
Individual
Gender
Male
Address
4150 Illinois Rd, Fort Wayne, IN, 46804-1208
Phone Number
260-702-3752
Fax Number
260-702-3752
Provider Enumeration Date
12/14/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4150 Illinois Rd
City
State
Zip
46804-1208
Phone Number
260-702-3752
Fax Number
260-702-3752
person
Provider Business Mailing Address Details
Address
4150 Illinois Rd
City
State
Zip
46804-1208
Phone Number
260-702-3752
Fax Number
260-702-3752
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
39002631A (Indiana)
Definition
Definition to come...
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