| NPI | 1699857227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D MCCOY Owner 765-529-3370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |