| NPI | 1104592617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DAVIS CEO/Owner 317-827-2987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |