| NPI | 1912922550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MICHAEL MCCROVITZ Executive Director 219-921-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IN 100110700) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-09-15 |