Individual
MS. MARY KATHLEEN AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
203 W WAYNE ST STE 317, FORT WAYNE, IN 46802-3610
(260) 333-9703
Mailing address
203 W WAYNE ST STE 317, FORT WAYNE, IN 46802-3610
(260) 333-9703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006941A
IN
Other
Enumeration date
01/28/2018
Last updated
09/13/2021
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