| NPI | 1962192955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY JOHNS Owner 574-226-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-05-11 |