Individual
KRISTINA BAGNOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2211 SOUTH ST, LAFAYETTE, IN 47904-2968
(317) 210-0507
Mailing address
2211 SOUTH ST, LAFAYETTE, IN 47904-2968
(317) 210-0507
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35002295A
IN
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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