Individual
KAITLIN MARIE NINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSA, LCSW
Contact information
Practice address
1027 W RUDISILL BLVD # 207, FORT WAYNE, IN 46807-2160
(260) 225-3128
Mailing address
15610 GRASSY WILLOW DR, HUNTERTOWN, IN 46748-9117
(586) 530-0735
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34008811A
IN
Other
Enumeration date
01/06/2016
Last updated
01/16/2025
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