| NPI | 1336854694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NCOLE KOCH Therapist/Owner 616-617-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-01-20 |