| NPI | 1174267116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE DIANE LIST CEO 989-672-6160 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-08-15 |