| NPI | 1356853428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA V. STOVER Executive Director 219-386-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007467A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2021-01-04 |