| NPI | 1336650019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYBETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301007079) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2017-10-20 |