| NPI | 1578923405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA LYNN STOREY Mental Health Counselor 812-631-0056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001108A) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2024-01-26 |