| NPI | 1699727073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Director Of Billing 765-446-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 103T00000X) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-10-24 |