| NPI | 1568050292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATINA JOHNSON-FRY SMITH President/Director 317-845-8475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-07 |