| NPI | 1780337808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE MALLER Licensed Mental Health Counselor 574-208-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-29 |
| Last Update Date | 2022-01-29 |