| NPI | 1558441063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERE W LEIB President 260-482-8427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TF0200X Psychologist, Forensic | |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2025-09-11 |