| NPI | 1639830151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSITA FERNANDEZ Owner/Psychologist 812-201-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-02-09 |