| NPI | 1679810444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ALYCE BRYANT BISSEY Clinical Psychologist 812-374-2282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042096A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002087A) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2013-01-13 |
| Last Update Date | 2013-01-13 |