| NPI | 1306351408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA CHRISTINE OTT Licensed Clinicial Social Worker 260-519-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005695A) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |