| NPI | 1821249079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M. DURAK Clinical Psychologsit 219-464-7678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN 20090233A) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2009-09-24 |