Sean Alexander Abraham
Social Worker, Clinical in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1780210872
StatusActive
Last updated in NPPESMay 23, 2023
Details
- NPI
- 1780210872
- Entity type
- Individual (NPI-1)
- Name
- Sean Alexander Abraham
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2020
- Certification date
- May 23, 2023
- Last updated
- May 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34009731A | IN | Yes |
| 104100000X | Social Worker | 99095041A | IN |
Practice location
5534 Saint Joe RdFort Wayne, IN 46835-3328
Phone 812-200-0513
Mailing address
3204 S Walnut Springs DrBloomington, IN 47401-7422
Phone 317-540-4358
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