| NPI | 1033702360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANA MARIE STRAVERS Member/ Owner 616-502-9681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-06-14 |