NPI | 1487776332 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE RICHARDSON Owner 616-235-2090 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704110245) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2014-11-04 |