| NPI | 1487873659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PHELPS Executive Director 269-375-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401004079) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301001601) |
| 103TC1900X Psychologist Counseling (Licence: MI 6301007397) | |
| 106H00000X Marriage & Family Therapist (Licence: MI 6401004079) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |