| NPI | 1720250756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | F. GEOFFREY SAMORA President 574-232-5065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34002397A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39000590A) |
| 103T00000X Psychologist (Licence: IN 20040221A) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2011-12-07 |