NPI | 1811396567 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN W MOODY Owner 765-461-3033 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005092A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000247A) |
1041C0700X Social Worker, Clinical (Licence: 34005092) | |
Enumeration Date | 2014-08-19 |
Last Update Date | 2022-07-21 |