| NPI | 1316799380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL YBARRA Owner/President 260-241-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-09-22 |