| NPI | 1679858831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANIE D HEATH Billing And Insurance Manager 317-241-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20042331A) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2024-04-17 |