| NPI | 1205283660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM DONOVAN Administrative Assistant 765-587-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |