| NPI | 1235557844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA KLOTT Owner 616-204-5828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-02-18 |