| NPI | 1184612137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA HANCOCK Clinical Director 574-232-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2012-10-31 |