| NPI | 1205017738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG A DE WITT Owner 616-957-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2016-03-09 |