Most Relevant Information
Provider Data
| NPI Number: | 1003236613 |
| Provider Name: | JENNIFER PERRY MS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/22/2014 |
| Last Updated: | 04/22/2014 |
Provider Practice Location
909 E STATE BLVD
FORT WAYNE
IN
468053404
Practice Location Phone/Fax
| Phone: | 2604812700 |
| Fax: | 2604812709 |
Provider Mailing Location
909 E STATE BLVD
FORT WAYNE
IN
468053404
Provider Mailing Phone/Fax
| Phone: | 2604812700 |
| Fax: | 2604812709 |