| NPI | 1437280740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY E LILLY Owner 812-346-7744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042033A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2014-07-01 |