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 |