| NPI | 1144039710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LYNN WIEGAND Owner 231-750-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-01-07 |