| NPI | 1740985795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BURBAGE Psychologist 317-509-5113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2023-03-31 |