| NPI | 1710153010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EUGENE DICKENS Agency Director 317-549-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IN 39000099A) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist (Licence: IN 35001499A) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |