| NPI | 1720201007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E. NOLL Psychologist 219-465-7674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20010455A) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2010-04-27 |