| NPI | 1295220846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401014374) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2022-01-27 |