| NPI | 1720436488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA D ANDERSON Director Of Compliance 765-289-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20042451) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: IN 20042827) |
| 103TH0100X Psychologist, Health Service (Licence: IN 20042841) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01038611) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |