| NPI | 1508591710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA VANDENBURGH Owner 317-500-4789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-21 |