| NPI | 1275993909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA MCCOMBS-MATLOCK Psychologist 765-446-6525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 99071250A) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2019-08-06 |