| NPI | 1639685571 |
|---|---|
| Doing Business As | MINI MINDS |
| Entity Type | Organization |
| Authorized Contact | KRISTIN KOUKA Owner 317-460-2384 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |