| NPI | 1659911832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN GODDARD Owner 812-226-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2024-02-21 |