| NPI | 1912121070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL DORMIRE POWERS Psychologist 260-490-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20040449A) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |