| NPI | 1053589036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K MCINTYRE Owner 269-465-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301010904) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801071984) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-07-10 |