| NPI | 1558484030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEVA E HAGEDORN Counselor 317-353-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 33005191A) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-08-22 |