| NPI | 1396180659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L. LALA Licensed Clinical Social Worker 574-344-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003589A) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |