| NPI | 1588120737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIJI C. GAMBLE Owner, Counselor 269-903-4535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2023-11-28 |