OrganizationActive
Fort Wayne Neuropsychology LLC
NPI 1871032862 · Clinical Neuropsychologist · Fort Wayne, IN
Provider details
- NPI number
- 1871032862
- Entity type
- Organization
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Tasha Williams, Vice President(260) 414-8629
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Practice location
4306 E State Blvd
Fort Wayne, IN 46815-6915
Phone: (260) 460-3100
Approximate (ZIP-level) locationGet directions
Mailing address
4306 E State Blvd
Fort Wayne, IN 46815-6915
Registry dates
- Enumerated
- 2017-02-23
- Last updated
- 2017-02-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.