| NPI | 1134233596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY HYDE Managing Member 219-756-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041813A) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2010-07-14 |