| NPI | 1174124648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE COOPER Owner 317-449-9418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |