| NPI | 1699142844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER L JOHNSTON Co Owner 260-498-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN IN34004652A) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-09-13 |