| NPI | 1073054359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN RIGONI-SOUTHLAND Director 269-743-6139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401008766) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301011550) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |