| NPI | 1467722942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M. SHIVE Owner 248-844-2647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401006821) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401006446) |
| 101YM0800X Counselor Mental Health (Licence: MI 6401006446) | |
| 101YM0800X Counselor Mental Health (Licence: MI 6401006821) | |
| 101YP1600X Counselor Pastoral (Licence: MI 6401006821) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301011685) | |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2016-02-11 |