| NPI | 1801481106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY LEVIN Manager 317-296-7730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2022-01-12 |