| NPI | 1598810137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA JEAN WYNN-STELT Co Owner 616-647-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301008405) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301008405) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6301012332) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301012332) | |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801083017) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-02-06 |