| NPI | 1003374638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE SMITH Licensed Clinical Social Worker 219-743-9017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-03-02 |
| Last Update Date | 2019-03-02 |