| NPI | 1083397962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE STARKS Licensed Masters In Social Work 269-930-4112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |