| NPI | 1518350370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDINE MARIA WAGGLE Mental Health Therapist 317-902-6724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005160A) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |