NPI 1457906067

Jennifer L Rubalcada

Practitioner Prevention Professional Fort Wayne, IN

Practice location

Address: 1101 W Oakdale Dr, Fort Wayne, IN 46807-1747
Phone: (260) 246-0132

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence NA (IN)

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Registry record

NPI: 1457906067
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Aug 2019
Record last updated: 9 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.