| NPI | 1083133656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE KAY BURKHARDT Owner 260-519-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001475A) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-07-21 |