| NPI | 1093260515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELIA J SUBLETT Owner 317-560-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34006458A) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |