| NPI | 1447868906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY THOMAS ANTONELLI CEO/Psychotherapist 765-480-0594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 1041S0200X Social Worker, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |