| NPI | 1245402783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LEE IMEL Owner 765-281-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001395A) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2013-09-10 |