| NPI | 1902406747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL ANN CAMPBELL Licensed Clinical Social Worker 765-434-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |