| NPI | 1972710481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELENA B. WISMAN Owner 812-206-3291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001423A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34003588A) |
| 1041C0700X Social Worker, Clinical (Licence: IN 34004562A) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 1042) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2014-12-19 |