Brosh INC
Social Worker, Clinical in Fort Wayne, IN. Organization (NPI-2).
NPI number1164060653
StatusActive
Last updated in NPPESDec 15, 2019
Details
- NPI
- 1164060653
- Entity type
- Organization (NPI-2)
- Legal business name
- Brosh INC
- Organization subpart
- No
- Enumeration date
- Dec 15, 2019
- Certification date
- Dec 15, 2019
- Last updated
- Dec 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
4820 Oak Knob RunFort Wayne, IN 46845-8939
Phone 260-249-5432
Mailing address
4820 Oak Knob RunFort Wayne, IN 46845-8939
Authorized official
Bree Ricker
Licensed Clinical Social Worker
2602495432
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