| NPI | 1942438718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L FREEZE Practice Administrator 219-926-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20042094A) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2012-12-03 |