| NPI | 1245769314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401012026) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2023-03-07 |