| NPI | 1033318340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALLEN DERROR Executive Director 231-878-3059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013463) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401004326) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |