Individual
DR. TERI MARISA KRAKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9500
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043109A
IN
Other
Enumeration date
01/12/2018
Last updated
12/26/2019
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