| NPI | 1003329582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYBETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010373) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |