| NPI | 1043825664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |