| NPI | 1437784188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LAUREN FOKSA Owner 269-389-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2023-09-21 |