| NPI | 1740795640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENELLE LINDEN Member Owner 812-902-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002692A) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2021-04-16 |