| NPI | 1356547962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LEE WIELAND President/Psychologist 260-483-7207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20041419A) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2016-10-28 |