| NPI | 1790291755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JO GONZALEZ Owner Of Practice 260-446-8058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007818A) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |