| NPI | 1487068458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DOHERTY Owner 616-464-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301011612) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401009797) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |