| NPI | 1467939462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L FORD Licensed Mental Health Counselor 317-528-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 39003318A) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |