| NPI | 1871032862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA H. WILLIAMS Vice President 260-414-8629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |