| NPI | 1174899488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MICHAEL ALLEN Clinical Psychologist 219-898-5645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN 20042166A) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |