| NPI | 1154488773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA K. SHAIN Clinical Social Worker 765-827-5610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004224A) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-06-20 |