| NPI | 1821509126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA BLOSS Owner 317-743-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.009611) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2022-12-12 |