| NPI | 1023221207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE BEVILL-DADA President/COO 260-492-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001423A) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IN 2004070712A) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-06-26 |