| NPI | 1033394101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE D GODSEY Billing Manager 812-824-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041898A) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2009-02-04 |