| NPI | 1194232298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA LILLY Professional Counselor 616-366-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401015662) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |