| NPI | 1083159909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HANKEE Member 317-417-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN 20042204A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IN 02002848A) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2023-11-01 |