| NPI | 1740526623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN CIASTKO Provider/Owner 574-855-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002221a) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2013-09-04 |