Graduated: 1984
NPI: 1689899486
Practice Locations (2)
FORT WAYNE NEUROPSYCHOLOGY LLC
4306 E STATE BLVD
FORT WAYNE, IN 468156915
2604063203
FORT WAYNE NEUROPSYCHOLOGY LLC
PO BOX, SUITE 10268
FORT WAYNE, IN 468510268
Source: CMS National Downloadable File, September 2026.