| NPI | 1073718623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LAMPKE Accounts Manager 765-288-7939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34001741A) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |