| NPI | 1174693808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY STEWART STEVENS Owner/Member 269-806-9571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-08-26 |