| NPI | 1366680902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON M DICKERSON President/Therapist 317-446-4943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2010-01-14 |