| NPI | 1245585157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL LYNN MICKELSON Clinical Psychologist 574-243-9370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042493A) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |