| NPI | 1255439709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE MARSHALL GERARD Owner President 260-422-9372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34001586A) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |