| NPI | 1003661299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERYNE KOPP MILLER Clinical Psychologist 765-425-3412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |