| NPI | 1548514656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOCKE Psychologist 260-436-7131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20040180) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |