| NPI | 1336877380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE V JONES Billing And Credentialing 810-422-5474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-08-11 |