| NPI | 1881987295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JO NIBBS Owner 317-752-7019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-09-21 |