| NPI | 1275038523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301010207) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |