NPI | 1104996719 |
---|---|
Entity Type | Organization |
Authorized Contact | PHILIP SCOTT PARKER President, CEO 317-650-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041153A) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2020-08-22 |