| NPI | 1306289293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA S HUBERT Outpatient Therapist 812-453-8543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: KY 3407) |
| Additional Taxonomies | 251S00000X (Licence: KY 0981) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-10-04 |