NPI | 1841872082 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT RUSSELL DUNEVANT Supervisor And Psychotherapist 219-916-0822 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2021-04-27 |
Last Update Date | 2021-04-27 |