| NPI | 1205392099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LYNN SANDERSON Owner/Member 248-396-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-16 |
| Last Update Date | 2022-07-22 |