| NPI | 1972843340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON BLAINE DETWILER Owner 574-534-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34006654A) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2013-02-22 |