| NPI | 1316694375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN J SHEPARD Owner 812-502-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-11 |