| NPI | 1336579754 |
|---|---|
| Doing Business As | ICAN |
| Entity Type | Organization |
| Authorized Contact | MARLA JEAN SOUDER President/COO 260-498-9933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: IN 20042225A) | |
| 103TS0200X Psychologist, School | |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| 222Q00000X Developmental Therapist | |
| 225100000X Physical Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2013-11-21 |