| NPI | 1033958475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN RILEY TASKER Co Owner/Counselor 810-618-4374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363AM0700X Physician Assistant, Medical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-06-14 |