| NPI | 1609491521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHURKELA LA VETTE MASON Clinical Director/Therapist 810-853-9795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |