Individual
KENDRA MIKLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LCACA
Contact information
Practice address
2200 LAKE AVE, 260, FORT WAYNE, IN 46805-5351
(260) 424-0411
(260) 424-3530
Mailing address
4619 BEAVER AVE, FORT WAYNE, IN 46807-2901
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
87900086A
IN
104100000X
Social Worker
33011221A
IN
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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