| NPI | 1083184196 |
|---|---|
| Doing Business As | FAMILY PSYCHOLOGY OF SOUTH BEND |
| Entity Type | Organization |
| Authorized Contact | JOHN ANTHONY PETERSEN Manager 574-280-8199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0000X Psychologist, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2018-12-01 |
| Last Update Date | 2018-12-01 |