| NPI | 1134811557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LYNN ZAVALETA Owner 317-992-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |