| NPI | 1003859984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HECKMAN Practice Manager 616-458-0692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2025-01-02 |