NPI | 1942648761 |
---|---|
Entity Type | Organization |
Authorized Contact | ERICKA SWANSON Owner 219-805-0451 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007992) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071008135) |
103TC0700X Psychologist, Clinical (Licence: IL 071007988) | |
Enumeration Date | 2013-06-14 |
Last Update Date | 2022-07-12 |