| NPI | 1871002121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER L JOHNSTON Owner 260-498-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34004652A) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2022-07-21 |