| NPI | 1194869511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CAMPBELL Administrator 269-349-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 2557) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2022-12-08 |