| NPI | 1619480928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA M JOHNSTON Owner 269-998-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401009761) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |