| NPI | 1831615665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR KATHLEEN LOCKER Owner 765-637-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20043054A) |
| 103TC1900X Psychologist, Counseling | |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2023-09-05 |