Provider Demographics
NPI:1003702960
Name:COLGLAZIER, MOLLY CHRISTINA
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:CHRISTINA
Last Name:COLGLAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10102 WOODLAND PLAZA CV STE A
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1573
Mailing Address - Country:US
Mailing Address - Phone:260-240-4200
Mailing Address - Fax:
Practice Address - Street 1:10102 WOODLAND PLAZA CV STE A
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1573
Practice Address - Country:US
Practice Address - Phone:260-240-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health