| NPI | 1710342746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | K. RANDALL MILLER Owner/Provider/President 260-710-8175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002091A) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |