| NPI | 1407877657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY R HAWKS Office Manager 260-471-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103G00000X Clinical Neuropsychologist | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-08-26 |