| NPI | 1750036000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA RAE CHURCH Practice Owner 812-230-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |