| NPI | 1972887479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M GUDAN Psychologist 317-455-6782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20042547A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20042547A) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2020-04-15 |