| NPI | 1083259345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELBA LYNETTE CLARK Licensed Professional Counselor 231-343-0630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2020-02-07 |