| NPI | 1952959363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANNE RILEY Tin Owner 812-604-7718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2025-09-18 |