Individual
DESTINA EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3514 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 255-6432
Mailing address
3478 STELLHORN RD, FORT WAYNE, IN 46815-4630
(260) 452-5336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/13/2022
Last updated
07/01/2025
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