| NPI | 1003522061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NAUMANN Office Manager 269-795-6681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-04-03 |