| NPI | 1275063661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALITHA EASTERLY Owner 517-225-4373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301017005) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2017-06-18 |