| NPI | 1306616735 |
|---|---|
| Doing Business As | HERON RIDGE ASSOCIATES OF MICHIGAN |
| Entity Type | Organization |
| Authorized Contact | LESLIE JOHNSON CEO 704-506-6267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-03-13 |