| NPI | 1457665028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY FREEZE Practice Consultant 219-926-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C001026) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |