| NPI | 1649773102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH K GLASS Owner 317-523-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2020-10-28 |