| NPI | 1124516000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LAMANCUSA Business Owner 616-364-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301012462) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |