| NPI | 1114059953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MIRRO Psychologist/Owner 219-805-7407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041970A) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2022-12-21 |