| NPI | 1497290118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301013811) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2023-04-06 |