| NPI | 1689075285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT MCCRANDALL Accountant 734-769-0209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 6201097288) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |