| NPI | 1063941599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY YOUNGBLOOD Psychotherapist 269-213-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801098813) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006666) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-08-02 |