| NPI | 1336244656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J WORTHINGTON President 231-932-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012248) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |