| NPI | 1730261835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY RANELL SHETLER Owner 574-534-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041401A) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-10-01 |