| NPI | 1962654509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE PARKER President 765-506-2215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041950A) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |