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MR. JUSTIN DOMINIC AQUILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHCA

Contact information

Practice address
10102 WOODLAND PLAZA CV STE A, FORT WAYNE, IN 46825-1573
(260) 440-3150
Mailing address
10102 WOODLAND PLAZA CV STE A, FORT WAYNE, IN 46825-1573
(260) 440-3150

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88002895A
IN
101YM0800X
Mental Health Counselor
C.2405825-TRNE
OH

Other

Enumeration date
08/13/2024
Last updated
08/13/2025
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