| NPI | 1023063724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRONSON TROYER Administrator 317-963-7285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01053884) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20010381) |
| 103TC0700X Psychologist, Clinical (Licence: IN 34004399) | |
| 104100000X Social Worker | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: IN 20010163) | |
| 2084N0600X (Licence: IN 20041914) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 70000020) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IN 01032989) | |
| 1041C0700X Social Worker, Clinical (Licence: IN 34000590) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20042875) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2015-08-27 |