| NPI | 1033552310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERAD MICHAEL DALTON Member 317-818-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2023-05-08 |