| NPI | 1174130850 |
|---|---|
| Former Legal Business Name | TIMBER CREEK COUNSELING WEST LLC |
| Entity Type | Organization |
| Authorized Contact | MARK SANDERS Owner/Clinical Director 616-520-8046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-03-28 |