| NPI | 1558748038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LAQUITA RAINEY Clinical Counselor 517-394-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014380) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401014378) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-06-30 |