| NPI | 1619927142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY SUE BOCK Office Manager 616-949-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-07-29 |