| NPI | 1790849610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNAH LEIGH DEVAULT Therapist 765-446-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33005046A) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |