| NPI | 1295211076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA MARIE JANSEN Practice Manager 616-591-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012067) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-06-26 |