| NPI | 1376833715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD MOE Supervisor 317-683-6533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 350000528) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |