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 |