| NPI | 1275764896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON SMITH Executive Director 219-981-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042301A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34001842A) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |