| NPI | 1013373836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M YATES Counselor 219-608-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002765A) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |