| Krista Agler Llc | |
|
109 Airport North Office Park Fort Wayne IN 46825-6701 | |
| (260) 255-4347 | |
| Not Available |
| Full Name | Krista Agler Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 109 Airport North Office Park, Fort Wayne, Indiana |
| Authorized Official Name and Position | Krista Agler (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 2603410449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krista Agler Llc 1230 Elmwood Ave Fort Wayne IN 46805-4213 Ph: () - | Krista Agler Llc 109 Airport North Office Park Fort Wayne IN 46825-6701 Ph: (260) 255-4347 |
| NPI Number | 1629562319 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 06/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629562319 | NPI | - | NPPES |
| 1326460882 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 39002962A (Indiana) | Primary |
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