| NPI | 1366995334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Billing/Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401015490) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |