| NPI | 1073394599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB M MOON Owner 616-626-1082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-02-18 |