NPI 1790350221

Christine O'Leary

Practitioner Prevention Professional Fort Wayne, IN

Practice location

Address: 5902 Homestead Rd, Fort Wayne, IN 46814-4202
Phone: (260) 434-0207

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 24007106A (IN)

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Registry record

NPI: 1790350221
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 May 2021
Record last updated: 26 May 2021

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.