| NPI | 1013366251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE M TILT Owner & Registered Dietitian 765-630-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-12-23 |