| NPI | 1033659073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401007531) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |