| NPI | 1952721540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MARTENS Co Owner 765-398-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001718A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001192A) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-03-26 |