| NPI | 1114615572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GRIFFIOEN Owner 269-888-3839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 133V00000X Dietitian, Registered | |
| 171400000X | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |