| NPI | 1336682988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Billing/Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301015853) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |