NPI | 1821750167 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGIE GRAFF Contracting & Credentialing Manager 317-376-8336 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
Additional Taxonomies | 103T00000X Psychologist |
103TC0700X Psychologist, Clinical | |
Enumeration Date | 2021-10-13 |
Last Update Date | 2021-10-13 |