Jacob M Fawley
Jacob M Fawley is a Mental Health Counselor in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2021.
- Licensed in
- IN
- In the registry since
- 2021
Practice location Address checks out
4150 Illinois RdFort Wayne, IN 46804-1208
Phone: (260) 702-3752
Fax: (260) 702-3752
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X · Licence 39002631A (IN) |
|---|
Record details
| NPI number | 1528727807 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | December 14, 2021 |
| Last updated in NPPES | December 14, 2021 |
| Certification date | December 14, 2021 |
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