| NPI | 1659805497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 4010115925) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |