| NPI | 1104018985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MARK SMITH Marriage & Family Therapist 317-466-9809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 35001463A) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |