| NPI | 1033587795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MARIE GARRY Master's Level Contract Clinician 317-697-8932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL ISW10093) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |