| NPI | 1356475172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE E. GILMORE Office Manager Secretary 317-585-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |