| NPI | 1477204881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WHITLOW Owner/Employee 574-210-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |