| NPI | 1811246507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER SECREST Office Manager 317-730-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042084A) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2025-11-19 |